CMS's Slavitt: Healthcare can’t rely on old ways in ‘new normal’

CMS Acting Administrator Andy Slavitt said the healthcare industry’s move away from volume and towards value-based care will be worth the short-term disruption in remarks to the American Academy of Actuaries.

Speaking at the academy’s annual meeting in Washington, D.C., Slavitt included many of his common remarks about the advances made since the Affordable Care Act (ACA), like the reduction in the uninsured population. He warned against “retreating” to pre-ACA policies, arguing market forces on their own “created little inclination to make things better.”

“For the crowd who believes we should go back to the old normal, I bet very few have been in the position where they’ve ever had to declare bankruptcy from cancer or had to tell their daughter she couldn’t play on the volleyball team because ‘mommy doesn’t have health insurance for you,’” Slavitt said. “To the people we interact with every day, who say they can sleep well at night because of the ACA, we need to keep moving forward.”

Forward, to Slavitt, means testing models which incentivize prevention (like the expanded Medicare diabetes prevention program), emphasizing better care coordination and “paying more for what works.” Tweaking the ACA should be considered, he said, in areas such as price transparency for hospitals and primary care providers.

The overall theme of his remarks was accepting the “new normal” in healthcare and learning how to adapt to it.

“For the consumer who’s used to making trips to the ER, it’s learning all the preventive and primary care avenues that are available to them; for the health plan, it’s adapting the past business model designed around underwriting—to one around new care and network management approaches; for the hospital, it is learning how to make money when beds are empty, not by filling them. To continue to succeed in the new normal, we can’t take the old rules into the new world without making adjustments,” Slavitt said.

Slavitt noted in his conclusion his time in charge of CMS is nearing its end. In August, Bloomberg reported he’s unlikely to be kept on in the new presidential administration, even if Democratic candidate Hillary Clinton wins on Nov. 8.