Change is coming: what to expect from Verma's CMS

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Emily Mongan
Emily Mongan

With former Georgia Congressman Tom Price confirmed as the new head of the Department of Health and Human Services, it's time to turn the focus on the person picked by President Donald Trump to helm the agency most closely linked to long-term care.

Seema Verma, nominee for administrator of the Centers for Medicare & Medicaid Services, will have her confirmation hearing with the Senate Finance Committee on Thursday. We have some ideas of how Price's past policies may impact the Medicaid and Medicare programs. But what can providers expect if Verma is confirmed?

For background, Verma is the president and CEO of SVC Inc., a consultancy firm based in Indiana. That location put Verma in a position to work closely with then-Governor, now Vice President Mike Pence on expanding Medicaid in the state. The majority of Verma's work has been focused on the Medicaid program, bringing some past CMS officials to speculate that she'll delegate Medicare-related responsibilities to others.

On the Medicaid front, Verma is a supporter of giving states more control over the program. The plan she helped shape in Indiana — one that relies on personal accounts to encourage beneficiaries to manage their care — has been praised by Price as a “national model for state-led Medicaid reforms pertaining to the low-income, able-bodied adult population,” CQ Roll Call reported.

Verma has also spoken out over perceived issues with the program's efficiency and quality, telling the House Energy and Commerce Committee's Subcommittee on Health in 2013 that Medicaid's shortcomings become more glaring when states debate expansion. She also used that testimony to champion reform of the program.

“Reluctance to expand is not indifference to the plight of the uninsured, but trepidation for the fiscal sustainability of the program and knowledge that expanding without reform will have serious consequences on Medicaid's core mission to serve the neediest of Americans,” Verma said.

Small changes have already been proposed for Medicaid this year, a possible sign of lawmakers' efforts to revamp the program under the new administration. That looming overhaul would become an even stronger possibility under a Verma-led CMS, seeing as she's called for Medicaid reform that takes the focus off of compliance and hands the reigns over to states.

“At Medicaid's core is a flawed structure,” Verma said. “A fundamental paradigm shift in management is required and the program should be reengineered away from compliance with bureaucratic policies that do not change results to aligning incentives for states, providers and recipients to improve outcomes.”

While Verma's testimony is nearly four years old, it's fair to assume her Medicaid initiatives will look similar to those she called for in front of the House committee, especially under an administration that has already made moves to reduce federal regulations.

So what comes next? Stay tuned to McKnight's this week for the latest news regarding Verma's confirmation hearing.

Follow Emily Mongan @emmongan.


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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.