RISE summarizes the latest headlines that impact Medicare and Medicaid.
Who’s who on the Biden health care team – for now
Although the Biden administration has yet to nominate a permanent administrator for the Centers for Medicare & Medicaid Services (CMS) to replace Seema Verma, it announced that Liz Richter will serve as the acting administrator in the meantime.
Richter has worked with CMS for more than 30 years, according to the bio on the CMS website. She began in 1990 in the Bureau of Policy Development working on inpatient hospital payment policy. She subsequently worked on a variety of Medicare payment issues. In 1998, Richter moved to the Office of Financial Management, where in 2001 she became director of the Financial Services Group. In 2003, she became director of the Hospital and Ambulatory Policy Group in the Center for Medicare Management and became deputy director of the Center for Medicare in 2007.
Also on the team: Jeff Wu, acting principal deputy director and deputy director for policy, Center for Consumer Information and Insurance Oversight (CCIIO). Wu leads the center’s work promulgating policy and regulations for many of the Affordable Care Act’s health insurance reforms, including the Health Insurance Marketplaces (including SHOP), the premium stabilization programs, advance payments of the premium tax credit and cost-sharing reductions, the CO-OP program, regulation of qualified health plans, and eligibility and enrollment standards. He oversees the center’s communications, stakeholder outreach, and data analysis work, and serves as a member of the center’s senior leadership team. He previously served in various policy positions at CCIIO, as an attorney at the law firm of Covington & Burling LLP, and as a management consultant with Oliver, Wyman & Company. He received an A.B. in economics from Harvard College, a J.D. from Stanford Law School, and an M.B.A. from Stanford Business School.
Norris Cochran will serve as acting secretary of the Department of Health and Human Services (HHS) until the confirmation of Xavier Becerra, Biden’s nominee for the permanent position. No hearings have been scheduled for Becerra, who is the attorney general in California. Cochran has served as the deputy assistant secretary for budget for nearly 12 years.
Rochelle P. Walensky, M.D., MPH, officially began her post as the 19th director of the Centers for Disease Control and Prevention (CDC) and the ninth administrator of the Agency for Toxic Substances and Disease Registry (ATSDR). Dr. Walensky comes to CDC from Massachusetts General Hospital, where she served as chief of the Division of Infectious Diseases from 2017-2020; and Harvard Medical School, where she served as professor of medicine from 2012-2020.
CMS reports drop in Medicare ACO participation in 2021
New data from CMS indicates that 477 Medicare accountable care organizations (ACO) will participate in the Shared Savings program in 2021, compared to 517 in 2020. The current ACOs are providing care to 10.7 million beneficiaries.
The National Association of ACOs notes that this is the lowest level of participation since the Trump administration took office four years ago. It’s highest level of participation was in 2018 when 561 ACOs were in the program.
The association blamed the drop in ACOs on several Trump-era policies, including 2018 changes which gave ACOs limited time before taking on financial risk and cut the share of savings most ACOs are eligible. Last year, due to the pandemic, CMS didn’t allow new ACOs to apply to join the program.
Despite the declining number of ACOs, the Shared Savings Program produced savings every year. It had its best year in 2019, the most recent year for which data is available when it saved Medicare $2.6 billion ($1.2 billion after accounting for shared savings bonuses and collecting shared loss payments).
Biden executive orders impact the health care industry
In his first days in office, President Joe Biden signed several executive orders that will impact the health care industry. Many of the actions will address the COVID-19 pandemic, including directives that create an office for COVID-19 response coordination, increase productions of supplies, boost testing capacity, rely on a data-driven response to COVID-19 and future pandemics, and mandate a mask wearing policy on federal property and air travel. He also released a 200-page national pandemic strategy.
He also signed an order that reverses the controversial directive made by the Trump administration to roll back protections for transgender people under the Affordable Care Act, which banned discrimination in health care.
"This executive action will not only undo four years of the government providing a license to discriminate against LGBTQ Americans but will ensure LGBTQ people are protected from discrimination in key areas of life and that the federal government is actively working to dismantle barriers to opportunity for LGBTQ people," said Winnie Stachelberg, executive vice president for External Affairs at the Center for American Progress. "But there still remains important work to be done. Congress must pass the Equality Act to ensure that all individuals receive the full measure of equality guaranteed to them under the Constitution—and that the rights of LGBTQ Americans are not left up to the whims of the person who sits in the Oval Office."