Slavitt shares CMS implementation goals for 2016

Successfully achieving change in healthcare is 90 percent about implementation, said Andy Slavitt, acting director of the Centers for Medicare & Medicaid Services (CMS), speaking at the 34th Annual J.P. Morgan Healthcare Conference in San Francisco. 2015 was the year for implementation for CMS, he said, from leading the largest data transparency transition in healthcare to new consumer websites to investing in the growth of Medicare Advantage and achieving record levels of quality and safety in patient care.  CMS works on three important levels, he explained: 1.) Setting policy and acting as regulator to make sure the laws Congress passes advance the interests of consumers and taxpayers. "Policy is often a blunt instrument but in the real world it takes continual adjustment." 2.) Act as operator, providing technical support, partnering with states and community programs. "Our mantra is 'give people the tools they need to thrive in the face of significant change." 3.) Market signaller, serving as a catalyst to bring together disparate parts of healthcare. 2016 is "an enormous pivotal year of progress and we're starting off with a bang," said Slavitt. CMS is advancing the agenda with the announcement of participants in the next generation ACO model in which provider groups take full financial responsiblity for patients' care. This model is driven by all the lessons learned from past models and "the news is very good." These 21 new ACOs bring the total to 475 with 30,000 participating physicians. There were 19 ACOs last year that were full risk and now there are 64. "My read of this news is that in 2016 we have more and better ACOs," Slavitt said. Of the 8.9 million Medicare fee-for-service beneficiaries, more than 1 in 5 will now be part of an ACO, with 1.6 million in better or advanced models. "Many wondered if ACOs would succeed or end up in the dustbin. As a recovering entrepreneur, I know that the first step is often the hardest part. ACOs have demostrated improvements in patient quality, patient experience and lowered costs. I think of the next gen model as similar to the second generation of the iPhone. We will have progress and setbacks, but continued improvement."  The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) "is squarely on our punch list. At the most basic level, it's a program that brings pay-for-value into the mainstream." The stakes are high, he said, but so are physician burden and frustration levels. Programs designed to improve often distract which "adds to the cynicism that the people who build these programs just don't get it." The goal is simplification. CMS is working with frontline physicians and others for direct feedback on the right measures for each specialty. "We're committed to building a program that's flexible. I would be remiss if i didn't add that we will start small and leave a lot of tool-building opportunities to the private sector."