Verma: CMS intends to disrupt healthcare by empowering patients

The agency wants to arm consumers with data that brings them into the decisionmaking process.


____simple_html_dom__voku__html_wrapper____>The status quo in healthcare isn’t working for patients who lack the information they need to make informed medical decisions, according to CMS Administrator Seema Verma.

Verma made the comments during Tuesday’s opening keynote session at HIMSS19 in Orlando, a day after the agency released its proposed rule to empower patient with access to their health data and to improve the interoperability of electronic healthcare records.

“We say another day at CMS is another day of disruption because we’re not trying to protect the status quo,” Verma told the audience. “Our rule yesterday really was about putting patients at the center of the healthcare system and empowering them.”

Also See: Proposed rules on electronic health information met with early industry approval

According to Verma, ensuring that patients have access to their medical records is one of the most important initiatives that the agency is pursuing, which she contends will have an impact on the entire healthcare system in terms of improving quality of care and lowering costs.

CMS wants to empower patients to be “consumers of healthcare” armed with data that “brings them into the decisionmaking.” Currently, Americans are “in the dark” because of a lack of pricing and quality information as well as difficulty in accessing medical records, said Verma.

“Yesterday’s rule was around insurance companies that have reams of claims data, which can be very powerful,” she added.

In its proposed rule, CMS wants to require that by 2020 all health plans doing business in Medicare, Medicaid and through the federal exchanges share claims and other health information with patients electronically through an application programming interface.

“When patients have the data, it gives them the ability to engage more in their healthcare,” according to Verma.

In the same HIMSS19 opening keynote session, Michael Leavitt, former governor of Utah and former secretary of Health and Human Services, said the power of consumers through APIs will reshape healthcare.

“People can submit information in a standardized way—by doing that, we’ll see the power of consumerism,” observed Leavitt. “That is a transformative idea and we had to learn these lessons.”

“This is a moment for us as an industry to step up—we need to see this rule as a call to action for the private sector,” added Leavitt. “For a long time, the government has been behind the commercial sector in moving this forward. The private sector is now behind the government.”

“My nature has been to deregulate,” commented Verma. “But, in this particular instance, the industry was not doing what was important, what is needed for patients and for the healthcare system. So, we’ve gone in this direction.”

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