Seema Verma, former administrator for the Centers for Medicare and Medicaid Services, had a clear goal for the American healthcare system: to ensure all Americans have access to affordable care while maintaining a high standard of quality. To achieve this, Verma believed that cost transparency and free market principles were necessary. She implemented new rules mandating price transparency in hospitals and required health insurance issuers to provide cost-sharing information unique to each plan. These reforms aimed to empower patients by providing them with clear cost information and the ability to make informed decisions about their healthcare.
Verma recognized that even with cost transparency, existing privacy regulations could hinder patients from transferring their health records to new providers. To address this, she pushed for reforms that would allow patients to easily access and share their medical records on their phones. She believed that this would lead to coordinated, high-quality care and better patient outcomes.
In addition to promoting price transparency, Verma implemented reforms that aimed to incentivize hospitals and doctors to lower the cost of their services without compromising quality. She reorganized payment structures, allowing surgery centers to compete fairly with hospitals and reimbursing providers based on results rather than the number of procedures performed. This shift to value-based care was intended to reduce costs and improve patient outcomes.
Verma’s efforts were not limited to Medicare, but also extended to Medicaid. She released guidance for state Medicaid directors to drive value in their programs and address the social determinants of health. She also made changes to the Medicaid drug rebate program to promote value-based payment.
While some of Verma’s reforms may not have remained in place after her exit from government, she continues to advocate for healthcare reform. Her vision is to build a future where optimal patient outcomes are achieved in a price-transparent healthcare system that prioritizes user choice and fosters ongoing competition.
All information and quotes in this article were sourced from reliable publications. (source links provided)
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