Regulation, science, and money: Those are the three factors Seema Verma, former administrator of the Centers for Medicare & Medicaid Services, has identified as impeding health care reform in the United States. During her 2017 to 2021 tenure — the longest-serving CMS administrator in modern history — Verma gained valuable insights into the future of healthcare and the obstacles that must be overcome to achieve meaningful reform.
Verma has been a vocal advocate for reducing government regulation in the healthcare industry, arguing that excessive bureaucratic barriers stifle innovation and drive up costs. In a speech at the 2019 American Medical Association annual meeting, she emphasized the need to redirect the U.S. healthcare system away from government regulation and toward free-market competition. Verma believes this shift will encourage innovation, improve care quality, and empower patients to make their own health care decisions.
“As CMS administrator, I made it a priority to tear down bureaucratic barriers to promote innovation, and I wanted to continue that focus in the private sector,” said Verma.
Seema Verma’s Listening Tour
To gather feedback on regulatory reform, Verma embarked on a national listening tour, meeting with representatives from various health care provider groups. During these meetings, stakeholders expressed concerns about the administrative burdens and compliance costs associated with health care regulations. The American Hospital Association reported that hospitals, health systems, and post-acute facilities spend a staggering $39 billion annually on compliance-related administrative tasks, equating to approximately $1,200 per admission.
The American Academy of Family Physicians President Michael Munger said, “I would characterize the global issue of administrative burden as the top issue in the family physician world, and I would guess for all physicians,”
Verma’s efforts to address regulatory burdens during her time at CMS included initiatives such as Patients Over Paperwork, which aimed to reduce administrative hurdles for providers.
“Patients belong at the center of the healthcare system,” stated Seema Verma. “For too long, they have been shunted aside, as mountains of paperwork distracted their clinicians and increased their bills. So we launched this initiative to right the ship: By getting rid of outdated regulations that don’t make sense, we have eased provider burden, reduced administrative costs, and put patients first.”
She also played a key role in developing the Acute Hospital Care at Home program, which granted hospitals unprecedented regulatory flexibility to care for patients in their homes during the pandemic.
The Impact of Scientific Advancements
Verma has acknowledged the role of science in shaping health care reform, recognizing that advances in medical technology, such as telehealth and remote patient monitoring, have facilitated an increased preference for home-based care.
“The shift to home-based care is a positive development,” she told Home Health Care News. “The advent of new technology, from telehealth to remote patient monitoring, is supporting the rapid adoption of home-based care.” However, adapting to these changes while ensuring safety, efficacy, and accessibility can complicate reform efforts.
The healthcare industry must strike a balance between embracing scientific advancements and ensuring that these innovations are properly integrated into the existing health care infrastructure. This requires a collaborative effort between policymakers, health care providers, and technology developers to create a framework that supports the safe and effective implementation of new technologies while minimizing disruptions to patient care.
Financial Hurdles
Financial considerations, including the rising cost of health care and the interests of various stakeholders, present another significant barrier to reform. The United States has the highest health care spending among developed nations, and costs continue to rise. Seema Verma has stressed the need to address these financial challenges, declaring, “There are ways to increase choices and drive down costs while still ensuring safe and quality treatment, but it requires government to get out of the way.”
During her tenure at CMS, Verma led numerous initiatives aimed at lowering costs, improving quality, and increasing access to care. These efforts included expanding Medicare Advantage, slashing insurance premiums, and the Patients Over Paperwork initiative. By focusing on cost-saving measures and promoting competition in the health care market, Verma believes that the United States can create a more financially sustainable health care system that benefits both patients and providers.
The Path Forward
Despite the challenges posed by regulation, science, and money, Seema Verma remains optimistic about the future of healthcare in the United States. She believes that by promoting innovation, reducing regulatory barriers, and fostering competition, the country can create a more efficient and patient-centered health care system. As she shared in an interview with Home Health Care News, “Government programs will need to keep pace with the innovation by changing policies to support more home-based care.”
Seema Verma’s insights into the factors impeding health care reform underscore the complex nature of the issue and the need for a multifaceted approach to address these challenges. By focusing on reducing regulatory burdens, embracing scientific advancements, and addressing financial constraints, the United States can make significant strides toward a more accessible, affordable, and innovative health care system that puts patients first.