Early Friday morning, the Senate voted 52-47 to confirm Tom Price as Secretary of the Department of Health and Human Services. Here’s what providers should know about Price and how his time at HHS might affect their strategy.
Secretary Price now assumes leadership of a department that controls over $1.1 trillion in annual federal spending and includes CMS, FDA, and NIH, among other agencies. The Senate Finance Committee will hold a hearing next week to consider the confirmation of Seema Verma, President Trump’s nominee for CMS Administrator. The president has yet to announce his nominees for FDA commissioner and NIH director.
In his new role, Secretary Price clearly will have a significant impact on the health care industry. So what should providers know about Price and how his time at HHS might affect their strategy?
1. Price is an orthopedic surgeon from Georgia who helped establish and run the largest independent orthopedic practice in the state
Price helped create the practice in 1999 through the merger of seven local physician groups. He worked in private practice for nearly two decades and later became medical director of the orthopedic clinic at Grady Memorial Hospital. Price says his experiences practicing medicine were part of his motivation to enter politics, and he is the first physician to lead HHS in more than 20 years.
2. Price, a vocal critic of the ACA, has authored a replacement plan that is similar to many other Republican proposals—but with a few notable differences.
Like most Republican plans, Price’s “Empowering Patients First Act” would grant tax credits for Americans to purchase insurance on the individual market, expand the availability of health savings accounts (HSAs), and require individuals to maintain continuous coverage to maintain pre-existing condition protections.
But Empowering Patients First differs from most Republican plans in some key areas: it would provide significantly less funding for state high-risk pools, eliminate Medicaid expansion, not reform Medicaid or Medicare—and is spelled out in legislative text, rather than as a policy paper. In his new role, Price has significant authority to regulate ongoing implementation of the ACA and will be able to influence Republicans’ efforts to draft and pass a replacement plan.
3. Price has said he supports innovative payment models, but opposes CMMI’s recent mandatory bundled payment programs.
During his confirmation hearings, Price said that the Center for Medicare & Medicaid Innovation (CMMI) has “great possibility and promise.” And in written comments, Price expressed support for testing innovative “healthcare financing and delivery” models and said that “ACOs are a tool in the toolbox to help ensure high quality, low cost health care for beneficiaries.”
He also has stressed—both before and after his nomination—that he opposes CMS’ mandatory bundled payment programs. While it is not clear what actions Price might take with regard to any specific models, it seems highly likely that payment reform will continue to move forward in some form.
4. Price voted in favor of MACRA and continues to express support for the new framework.
During his confirmation, Price highlighted MACRA as an example of bipartisanship and noted that the new system established by the law, “if implemented properly, will help ensure that seniors have better access to higher quality care.”
Price did co-author a letter on behalf of the GOP Doctors Caucus calling on CMS to make changes to its initial proposal for implementing MACRA. Commenting on the final rule, Price said that CMS “took steps to address physician concerns regarding the burdens associated with program participation” but added that “significant challenges remain with respect to provider burden.” Providers should anticipate that MACRA implementation will continue, but it may evolve under Price’s leadership.
5. Price has long advocated for reducing the administrative burden for physicians.
In his confirmation hearings, Price argued that administrative requirements on physicians detract from their ability to care for patients. Most notably, Price has frequently criticized the EHR Incentive Program. When asked about the meaningful use program during his confirmation hearing, Price noted that while EHRs are important, the federal government’s role “ought to be interoperability to make certain that different systems can talk to each other.”
It is not yet clear how Price’s perspective on EHRs and the government’s role will influence CMS policy, particularly with regard to MACRA, but many providers have long pointed at interoperability as a major barrier to efforts to improve care.