Elizabeth Newman, Senior Editor

Seema Verma is not messing around.

In a wide-ranging speech given at the 2019 CMS Quality Conference this week, the Centers for Medicare & Medicaid Services Administrator walked a fine line between reflecting a huge administration priority — less regulation — and making it clear CMS has no interest in flinging money at providers carte blanche.

“We are repositioning the government’s role from one prescribing processes through heavy regulation to one focused on safeguarding outcomes and taxpayers’ dollars,” Verma said.

She’s in an unenviable position of being a cabinet official in an administration led by someone who has no interest in details, especially the wonkier parts of healthcare policy. This isn’t a hot new take on President Trump — this is a person who cherishes talking about how he makes decisions based on his gut rather than traditional methods such as reading.

But I imagine it’s a challenge to be his underling when presenting the problems and benefits of legislation such as the Affordable Care Act, or discussing the future of Medicaid. Yet Verma does a far better job than, say, Secretary of Commerce Wilbur Ross, in projecting empathy for those of your residents who might be feeble, elderly and poor.

“Medicaid is a vital safety-net program that was created to care for society’s most vulnerable.  Let me be clear, this administration is firmly committed to this purpose,” Verma said. “We recognize the rising costs of the program threaten its sustainability. It is vital that we work to ensure that Medicaid meets the needs of the people who truly need it.”

She wants states to have more flexibility, and for CMS to be seen as a partner.

“In the last two years, we have made great strides in changing the reputation of CMS among states — once seen as an obstacle to reform, now a true partner and a catalyst for innovation,” she said. “Since taking office, we have approved over 50 Medicaid demonstration projects, including eight community engagement waivers, and 17 waivers to expand substance use disorder treatment.”

Verma touts how 20% of measurements have been removed because they were “topped out, duplicative, or simply overly burdensome to report for little gain.” She is clear that the industry needs quantifiable data — again, no one is going to give you funding without conditions attached —  but Verma said the “next generation of measurements” should lead to more transparency.

“First, measures must be patient focused, and easy to understand so consumers can use them to pick high-quality providers,” she said.

Additionally, in what should delight Republicans, she throws cold water on the leftist push of “Medicare for All.”

“We can barely afford the program we have,” she explained. “The trustees report that Medicare’s hospital insurance trust fund will run out in 2026, at which point the program won’t be able to pay all of its bills. And this issue is compounded by the challenge of caring for the baby boomer population, which is contributing more than 10,000 new Medicare beneficiaries every day.”

She adds that 17% of Medicare beneficiaries have six or more chronic conditions, and spending on that group alone is more than half of fee-for-service Medicare spending.

All of this is to say that the industry, as it looks at 2020, should want to know how politicians plan to pay for Medicare, in its current form or not.

No matter your political leanings, Verma harkens back to the days of a GOP where there is an agenda, but one where goals and opinions have been formed after studying facts and figures. It’s reasonably depressing to think someone is doing a good job in this administration because they appear to work hard, have knowledge about their field and have a base level of care about their fellow countrymen, but here we are. After all, as a division of the Department of Health and Human Services, CMS spent the first seven months of 2017 under Secretary Tom Price, one of the Trump administration heads to resign due to scandal. When that’s the bar, anyone else looks good.

Follow Senior Editor Elizabeth Newman @TigerELN.