Three things Dr. Oz can do as CMS administrator to solve America's health care problems

Dr. Mehmet Oz, nominated by President-elect Trump to be the next CMS administrator, will take over the reins of the agency that provides health insurance to more than 140 million Americans and accounts for a quarter of the nation's budget. , you'll have your hands full. Through bold, principled leadership and effective communication, he has the potential to effect positive and lasting change.

It's no secret that our health care system is broken. We continue to spend more and more money without seeing a clear return on investment in the health and well-being of our people. In fact, nearly 50% of Americans have at least one chronic disease, such as diabetes, high blood pressure, or obesity.

And when it comes to children, one study predicts that more than 220,000 people under the age of 20 will have type 2 diabetes by 2060, an increase of 700%.

When you combine these findings with health care workforce dissatisfaction and retention issues in the face of skyrocketing physician burnout and increasing needs for health care workers, unless we see tangible change, we believe You will face serious problems.

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CMS' efforts are critical to Robert F. Kennedy Jr.'s pledge to “make America healthy again.” There are several key areas that Dr. Oz can focus on to fulfill his role in this role as a CMS administrator.

Reduce regulatory burdens and barriers and put patients and their physicians back in the driver's seat of healthcare

For most doctors who see patients, it has become surprising how many computer clicks and extensive documentation a routine patient visit requires. This consumes and displaces valuable patient-physician face-to-face interaction time, gradually eroding satisfaction for both parties.

In a medical setting, most of your time should be spent treating patients, not computers, and is always important for optimal medical care. This will remove burdensome documentation requirements, restore efficiency in care, and reduce the current number of “quality” metrics (788 used in CMS quality, reporting, and payment programs in 2018) to help patients This means narrowing down to just a few indicators that are considered most important for the patient and their care. team.

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Governments should also remove regulatory barriers that limit where and how patients can get the care they deserve. For example, Oz and his team should work with Congress to remove geography-based restrictions on telemedicine. If you live in one state and travel to another state for treatment, you should be able to follow up with that medical team through telehealth without restrictions.

Additionally, patients should not be prohibited from using their homes to interact with their physicians through telehealth appointments. CMS's “hospital at home” exemption should also be extended or made permanent, allowing patients to receive acute care in the comfort of their own homes. Hospitals could be encouraged to develop these programs, which have been shown to reduce complications and reduce treatment costs by more than 30%.

This means ensuring the right patient receives care at the right time, in the right place, and from the right person. This unique improvement will have a dramatic positive impact on the access, efficiency, quality, and cost of healthcare.

Fostering competition to deliver the best care and reduce costs for patients and the country

Optimizing health and patient outcomes with the money America spends, and frankly our tax dollars, remains critical to “fixing” health care. Much of this can be achieved by aligning incentives and improving competition, which creates excellence and innovation.

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First, we should lift the ban on physician-owned hospitals, a meaningless rule built into the Affordable Care Act. This helps address ongoing concerns related to integration. Consolidation has the potential to reduce costs, improve quality of care, and put patients back on the “front line” above red tape and bureaucracy.

Second, in addition to improving oversight of price transparency compliance, Mr. Oz and his CMS team are working closely with Congress to ensure that price transparency regulations are codified. Should. This demonstrates the “staying power” of these price transparency rules, allowing entrepreneurs to make such information more patient-friendly and allow patients to “shop” for non-emergency goods and services more effectively. We encourage you to find practical solutions.

Third, medical payment is based on a bureaucratic piecework system (i.e., each time a doctor does something, a government-directed amount is paid, regardless of the outcome), which varies only depending on where the patient receives treatment. We must break away from the system of (That is, hospital facilities cost more money than outpatient facilities). Transforming healthcare means more routinely capturing and encouraging the outcomes that matter most to patients and are best suited to their well-being.

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Fourth, Medicare Advantage currently covers more than half of all Medicare-eligible Americans. I'm not going anywhere. Implementing improved competitive bidding payment models and prior authorization reform are two ways patients can receive better care at lower costs.

From payment models to healthcare workforce recruitment and retention to combating fraud and fraud, innovation must be front and center at CMS.

CMS and its Innovation Center should focus on streamlining the demonstration of new payment and care delivery models. As much flexibility as possible should be left to the discretion of local care teams, ensuring that these models are rolled out efficiently, with appropriate support where appropriate. States more quickly grant both Medicare and Medicaid waivers to better serve local markets, especially aging populations with chronic conditions and challenges accessing quality care. It could drive measurable savings and health improvements for Americans, who are often historically marginalized.

We also need to do a much better job of recruiting and retaining the best talent in healthcare. To that end, the savings from many of the policy options discussed here must be reinvested in training program improvements, preserving the viability of academic medical centers that train future clinicians, and developing innovative We need to take innovative approaches to support research efforts that lead to breakthroughs. , adjusting physician and employee compensation to better reflect inflation.

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Finally, Medicare and Medicaid lose more than $100 billion annually to fraud and fraud. Utilizing AI to screen and identify potential fraud and fraud is critical to protecting U.S. taxpayers from wasteful spending.

The future of health and healthcare

America's medical and health care system needs a complete overhaul. As Mr. Oz begins his term as CMS Administrator, we will continue to deliver on the promise of Medicare and Medicaid to those who truly need it, without continuing the out-of-control spending that has negatively impacted the future of this country. We have the opportunity to do better. In fact, it's essential if we want to “make America healthy again.”

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Christopher W. DiGiovanni, MD, is a professor of orthopedic surgery at Harvard Medical School and chief emeritus of the foot and ankle division at Massachusetts General Hospital. He is a past president of the American Orthopedic Foot and Ankle Society (AOFAS).

The opinions, thoughts, and ideas expressed in this article are those of the author alone and not necessarily those of the author's employer or organization.