CMS Administrator Seema Verma on Tuesday told insurers that they need to support the Trump administration’s policies on transparency, value-based payments, interoperability and data access, cautioning them that the health insurance industry is under threat from disgruntled patients, doctors and politicians.
Speaking at the America’s Health Insurance Plans’ 2019 National Conference on Medicare, Verma said that patients are tired of high costs, surprise bills and a system that’s too complex and difficult to navigate. She also noted that patients are unhappy with the hassles of insurance and worried that their claims would be denied, citing the low customer satisfaction ratings among private payers.
The administrator stated that providers are upset with private insurers, too, thanks to increasingly onerous administrative burdens such as prior authorization and quality reporting. Verma reiterated the oft-heard complaint that doctors spend too much time dealing with insurance claims instead of caring for their patients. She also cited evidence that it’s contributing to record-setting rates of burnout among physicians.
Verma went on to recount the events of this year’s American Medical Association annual meeting, where nearly half of the delegates voted to support Medicare for All, a measure that would essentially eliminate the private insurance industry.
“Consider that vote, the canary in the coal mine, warning of very real danger to the health insurance industry,” Verma told the audience of health insurance professionals.”
The administrator told onlookers that private payers had ignored patients and doctors since the passage of the Affordable Care Act. She said insurers need to adapt to the demands of the political landscape or they’ll “go extinct.”
“There’s a growing chorus to eliminate your industry entirely,” Verma warned.
So, she offered them an alternative. Verma said that if they embrace price and quality transparency and value-based payments, as well as the changes that enable them, they’ll thrive going forward. Verma said that improved technology and access to data are necessary to a multi-payer alignment strategy that includes private insurance.
She said that reducing the administrative burden for patients and providers would facilitate the adoption of value-based payments, which would ultimately be good for payers. Verma also promised to lower regulatory burden for private insurers and highlighted the administration’s efforts on value-based drug payments.
Date: October 03, 2019
Source: Modern Healthcare