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Former CMS administrators agree: Health IT needs more private development, less regulatory interference

Slavitt and McClellan say software is still not meeting the needs of clinicians and patients.
By Susan Morse
04:28 PM
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From left, John Kansky, Mark McClellan and Andy Slavitt at a fireside chat during HIMSS17 in Orlando on Monday.

ORLANDO - Former CMS acting administrator Andy Slavitt says the health IT marketplace is not addressing the real needs of patients and doctors, during a fireside chat with former CMS Acting Director Mark McClellan, MD.

John Kansky, CEO of the Indiana Health Information Exchange and a member of the HIMSS North America board of directors, served as moderator for this unusual opportunity to compare the perspective of CMS administrators from two different administrations.

The stage for this town hall was set by comments Slavitt made on twitter Feb. 10 in referring to his upcoming visit to HIMSS. Slavitt tweeted “… we’ve got this massive industry that puts on a great party and has massive shows and yet they have a customer base that is basically unsatisfied with the product. That seems like it’s where we should put all our energy.”

Moderator John Kansky did not directly address Slavitt’s tweet but but it provided an undercurrent for the discussion.

[See Video: John Kansky explains approach of HIE in Indiana]

McClellan said he would like to see more private sector leadership and Slavitt said he believes health IT software is being designed around regulatory hurdles instead of doctors and workflow issues.

Slavitt has been talking with physicians across the country in his informal role promoting the ACA. He has found that the health IT industry is siloing data, Slavitt said, and the products are still not doing what physicians and patients want.

“I’m talking like Trump,” Slavitt said. “You’re not satisfying the customers.  I’ve talked to thousands and thousands of physicians this past year, the majority don’t like the technology they’re using. It’s an enormous opportunity.”

McClellan said a big healthcare issue not being adequately addressed is healthcare disparity.

“One reason we got the election results we did …” he said.

Some areas are seeing a worsening life expectancy. The main determinants of health are lifestyle, he said. The country does a lot on healthcare but less on education.

“These are not easy problems to solve,” McClellan said. “What is clear is this will take time to sort out.”

On the Affordable Care Act, Slavitt said, “Many of us want to see it kept going.”

In his informal role since leaving CMS last month Slavitt has been travelling around the country, meeting with governors, patient groups and hospitals. He said that he would soon have a formal role promoting the Affordable Care Act in an organization he did not  name in Washington, D.C.

Repealing the ACA also means repealing the money, Slavitt said. “Everyone who built their lives around expansion are going to be very challenged,” he said.

Both agreed it should be a bipartisan effort.

“I think a lot of value based ideas are here to stay,” McClellan said.

“Fee-for-service is not leading to efficient care and technology is leaning more away (from hospitals) to stuff that happens at home, more precision, a more personalized basis.”

McClellan said he envisions more work through Medicare Advantage plans, MA Managed Care plans and more state-based efforts.

“A lot of payment reform has been on provider side,” McClellan said. “A lot shared savings could work well for consumers. Some commercial plans are doing chronic management and the like.”

Provider organizations at the top levels can push towards capitation, Slavitt said, while the folks in the middle tend to get stuck.  On bundled payments, Slavitt said he believes Health and Human Services Secretary Tom Price will back off a bit on his opposition to mandatory bundled payments.

“At CMS today, the information we provide is as important as how we make payments,” Slavitt said. “In that role, we’re highly dependent on private sector.”


This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.


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