Q&A with CMS Administrator Seema Verma

Seema Verma was sworn in as the 15^th Administrator of the Centers for Medicare & Medicaid Services on March 14, 2017. She brings deep experience in health care policy, Medicaid, insurance and public health to her role at CMS.

Administrator Verma is committed to empowering patients to take ownership of their healthcare and ensuring they have access to the resources they need to make informed decisions.

For more than two decades, Administrator Verma has guided health care policy in the public and private sector. She has worked with states to build flexibility into their Medicaid programs to help them meet the diverse needs of their unique populations. As the architect of the historic Healthy Indiana Plan, she helped create and implement the Nation’s first consumer-directed Medicaid program.

Continuing her efforts to improve health outcomes for all Americans, Administrator Verma is working toward a new era of state flexibility and local leadership at CMS. She aims to reduce burdensome regulations so doctors and providers can focus on providing high quality health care to patients. She also supports implementing innovative solutions that will improve health care quality, accessibility, and outcomes for states, while driving down costs.

Administrator Verma completed a master’s degree in public health with a concentration in health policy and management from Johns Hopkins University and a bachelor’s degree in life sciences from the University of Maryland. Previously she was the President, CEO, and founder of SVC, Inc., a national health policy consulting company.

Q. This was your first CMS Quality Conference as the Administrator of CMS. What were your key takeaways?

CMS and the Quality Improvement Organization (QIO) Program are teaming with and supporting 12,000 nursing homes, 4,000 hospitals, 400 community coalitions, and more than 500,000 clinicians across the country. Our shared work is making a difference in supporting quality health care. The large scope of our shared quality improvement work also means that rapid, meaningful results in priority areas such as addressing the opioid epidemic, reducing provider burden, behavioral health, patient safety, and rural health are within our reach.

CMS is also taking significant steps to reduce the number and complexity of quality measures to ensure we are easing the regulatory burden on providers and focusing on meaningful outcomes that are important to patients and clinicians. Regulations play an important role in ensuring the quality, integrity and safety of the health care system, but regulations should not be a roadblock to quality care. We need reasonable, practical approaches to quality measurement. This is reflected in our Patients Over Paperwork initiative to reduce burden and the Meaningful Measures initiative, which is ushering in a new approach to quality measurement.

Lastly, the conference helped reinforce my belief that we need the engagement of all of our partners—patients, caregivers, providers, Quality Innovation Network- and Beneficiary and Family Centered Care-QIOs, Hospital Improvement Innovation Networks, Transforming Clinical Practice Initiative Practice Transformation Networks and Support and Alignment Networks, End Stage Renal Disease Networks, and our Quality Payment Program-Small, Underserved, and Rural Support Networks, along with CMS employees—if we are going to make sure that we have the right quality measurements and that they are meaningful to patients and providers.

Q. The conference theme was “Patients Over Paperwork.” What does that mean to you?

Patients Over Paperwork is more than just a catchy slogan. It’s an announcement of our priorities that place patients first in everything we do to support quality care. With our health care system, providers are spending more and more time away from patients because they are filling out forms and complying with rules. We launched the Patients Over Paperwork initiative with the goal of reducing the regulatory burden imposed by CMS on our nation’s health care professionals. We are putting patients first by reviewing and streamlining our regulations so we can reduce unnecessary burden, increase efficiencies and improve the beneficiary experience. These efforts at CMS are part of President Trump’s “Cut The Red Tape” initiative that directs all federal agencies to take affirmative steps to reduce regulatory burden.

I encourage QIO News readers to visit our website and sign up for our Patients Over Paperwork newsletter to get ongoing updates on this initiative.

Q. As you reflect on your past year in office, what are you most proud of? 

I’m especially proud of the work we have done through our Meaningful Measures initiative. This effort takes a new approach to quality measurement to reduce the burden of reporting—and to help ensure that we’re truly paying for value and not volume. We’re revising current quality measures across all programs to ensure that measure sets are streamlined, outcomes-based and meaningful to doctors and patients. We also want to ensure that the measurements are easily reportable and that they are consistent and aligned across settings and programs as appropriate.

We’re already seeing progress. We removed a number of hospital quality measures and made changes to home health quality reporting, which resulted in burden reduction of over two million provider hours, giving doctors more time for patients.  It also saved millions of dollars. This is just the beginning. As CMS develops the next QIO Program plan, we will continue to focus on accountability for meaningful outcomes as well as providing flexibility and easing provider burden.

Q. Looking ahead, what are some of CMS’s priorities for 2018 and beyond that will shape the work of the QIO Program?

We have set four main goals. The first is to improve the CMS customer experience. Second, we’re ushering in an era of state flexibility and local leadership. Third, we are working to support innovative approaches to improving quality, accessibility and affordability. And fourth, we aim to empower patients and doctors to make decisions about their health care. These goals will be reflected throughout our work to support quality care including our Meaningful Measures and Patients Over Paperwork initiatives, the improvements we’re making to the Hospital Star Rating System, and the new Medicaid Scorecard.

Q. Your background is as a health policy consultant. What lessons learned from this private sector experience have you brought to your public service role at CMS?

For over twenty years, I have worked to help patients receive accessible, affordable and quality care. Before coming to CMS, I started my own consulting company. In that capacity, I worked with state governments and helped them design innovative programs. I also worked with the IT sector and worked on the front lines in hospitals. I learned that every state is unique and needs to be able to create programs to care for the needs of their citizens. With flexibility must also come accountability—we don’t want to tell states exactly how to care for their citizens, but we will hold them accountable for producing positive health outcomes.

Throughout my work, I have also come to realize that we undeniably have one of the world’s best health care systems, but that doesn’t mean that it is without its problems. One of our challenges is how we sustain this level of excellence as costs are growing. I am using my experience along with input from experts at CMS and our external partners to help us come up with innovative solutions that address improved quality and reduced costs to make our system sustainable over the long term.

Q. Anything else you’d like our readers to know?

At CMS, we know that our work is far from over. We look forward to continuing our efforts with the QIO Program and other health care quality stakeholders. We appreciate all that is being done to improve quality and health care throughout our nation. We need the benefit of expertise and experience as we move forward with all of our initiatives.

This story originally appeared in the March 2018 issue of QIO News.