- Big changes may be in store for healthcare under a new and unpredictable Presidential administration, but some familiar and experienced faces will be steering the ship at CMS and the Office of the National Coordinator (ONC) while the White House mulls over permanent replacements for key industry posts.
While candidate for HHS Secretary Rep. Tom Price waits for the results of his confirmation hearings, leaders at CMS and the ONC have already departed Washington, DC along with the Inauguration Day celebrants and subsequent protest crowds.
CMS Acting Administrator Andy Slavitt bowed out on January 20, turning his position over to his deputy Dr. Patrick Conway, whose commitment to health IT development and quality improvement is already well-known to the industry.
Conway, who previously served as CMS Acting Principal Deputy Administrator and Chief Medical Officer, has been in frequent communication with the industry through CMS blog posts, promoting the development of value-based care, explaining regulatory programs such as meaningful use and MACRA, breaking down CMS data related to quality improvement, patient safety, and care coordination.
He has been responsible for running the Center for Medicare and Medicaid Innovation (CMMI) as well as the Center for Clinical Standards and Quality (CCSQ), which oversees all CMS quality measures, Medicare coverage decisions, and value-based purchasing programs. With a $2 billion annual budget, CCSQ also certifies Medicare and Medicaid providers.
Slavitt, who has become a prolific tweeter in defense of the Affordable Care Act since the 2016 election, praised Conway for his healthcare experience and public service the day before relinquishing his title.
“For physicians and critics who rightly pointed out that I’m not a practicing doc, Patrick is,” Slavitt said on Twitter. “Patrick is also a profoundly good human and public servant. Medicare, Medicaid, and marketplace consumers will be in the best hands imaginable.”
Slavitt might be switching up his business cards, but he is planning to remain a prominent voice in the debate over the uncertain fate of the ACA.
As pundits probe the implications of an executive order allowing certain federal agencies the discretion to ease the economic burdens of the contentious healthcare law, Slavitt has affirmed his intentions to work with Congress, healthcare providers, and other industry stakeholders to secure a bipartisan solution to the thorny problem of revamping the legislation.
“Where I can have the most value is as a problem-solver — that is, to view things through a pragmatic lens and connect with both sides of the aisle,” he told Politico in an interview.
“[Healthcare consumers] want bipartisanship. And they want clarity. I spent two years trying to create stability and predictability for the market — and we did. But markets are only as good as people's belief in them."
Conway will no doubt have his hands full overseeing the first year of MACRA while facing tough challenges from consumers and industry stakeholders as Congress wends its way through the process of overhauling the ACA, but his long government tenure and experience at the highest levels of management are likely to be a benefit for CMS during this transitional time.
The ONC, which has generally seen quicker turnover among its leadership, is also changing hands again.
After a very short tenure as head of the Office of the National Coordinator, Dr. Vindell Washington has handed the top spot over to Acting National Coordinator Dr. Jon White, a family physician and experienced policymaker who has been partnering with the ONC in one capacity or another since 2004.
White previously served as Director of Division of Health IT at the Agency for Healthcare Research and Quality (AHRQ), and was also instrumental in developing the ONC’s Shared Nationwide Interoperability Roadmap and the 2015 report on information blocking that sparked an industry-wide movement to improve health information exchange across vendor lines.
His familiarity with the ONC’s interoperability efforts will serve him in good stead as the office works to upgrade the electronic health record market to the latest 2015 certification specifications while addressing the interoperability provisions of the new 21st Century Cures Act.
In his last blog post as National Coordinator, Washington praised his office’s role in helping the industry adopt health IT and improve interoperability, citing the 2016 multi-vendor agreement to share data as a particular highlight.
Public-private partnerships will continue to be vital for the ONC’s success as the industry attempts to architect and deploy more complex use cases for health IT tools, including patient-centered medication management, the development of FHIR and other APIs, and the advancement of precision medicine, Washington added, echoing sentiments expressed in a Health Affairs article earlier this month co-authored with fellow department head Slavitt.
"As HHS leaders continue this crucial dialogue, we look forward to hearing from you about what’s working today and what’s not, as well as your ideas about what the Federal Government and the private sector can do to make progress in this area," Slavitt and Washington wrote.
"It’s been a great honor working with the health care community and serving the American public. Working together across the health care landscape, the nation can move towards a truly 21st century data infrastructure that frees clinicians to confidently transition to value-based payment and realize better care, smarter spending, and healthier people."
Both the ONC and CMS will play a critical role in keeping the healthcare industry informed of how pending legislative changes are likely to influence the health IT landscape. The interim leaders of these critical agencies appear well equipped to deal with the challenges and opportunities of the new political era and its potential impact on the technology environment.