Will New CMS Initiatives Advance the Journey toward Patient-Centered Care?

May 7, 2018 Inovalon

To truly achieve value-based care, patients must be placed at the center of the healthcare system. This sentiment is front and center in CMS’ Data Driven Patient Care Strategy, an offshoot of the agency’s MyHealthEData initiative. Recognizing that data – quality data, cost data and patient-specific data – is what will drive a patient-centered system, CMS is seemingly dedicated to putting this data in the hands of patients, empowering them to make informed, educated decisions about their care.

MyHealthEData and Blue Button 2.0 Set the Stage for Patient Empowerment

With the goal of empowering patients by giving them control of their healthcare data, CMS Administrator Seema Verma introduced MyHealthEData, a government-led initiative “designed to empower patients around a common aim – giving every American control of their medical data.” To complement MyHealthEData, CMS also launched Medicare’s Blue Button 2.0, a secure way for Medicare patients to access and share their personal health data, enabling them to “connect their claims data to the secure applications, providers, services, and research programs they trust.” Blue Button 2.0 is a web-based data retrieval application programming interface that reveals four years of Part A, B, and D claims history data for 53 million Medicare members (at least one claim for each member), including the type of coverage, drug prescriptions, primary care treatment and cost.

To successfully execute on CMS’ goal of enabling patients to access and ultimately control their healthcare data, there must be transparency – including price transparency – on the parts of both payers and providers. Patients cannot make a fully informed decision about their healthcare unless there is more transparency regarding both quality of services and cost. On a patient-specific level, this also means that the data patients can access about their own medical history must be complete and accurate to have true impact on patient engagement and ultimately overall health outcomes. Currently, patient data is often disparate, lacking a “single source of truth” for patients, health plans and providers alike.

Patients as Consumers Is Poised to Change Patient and Provider Experience

The concept of patient-centered care is not new, and major players like Apple, which launched its Health Records earlier this year, are joining the movement. Patient-centeredness has been sought after in healthcare for decades, but although the healthcare community has largely embraced the concept in theory, in practice, execution of true patient-centered care remains a bit more challenging.

Voicing his own concerns regarding the challenges with delivering on the promise of patient-centered care, Alex Azar, U.S. Secretary of Health and Human Services asserted that “putting healthcare consumers in charge, letting them determine value, is a radical reorientation from the way that American healthcare has worked for the past century.”

For this new wave of healthcare – one in which patients will be fully engaged and positioned to take charge of their own care – to take hold, the entirety of healthcare needs to be better at empowering and supporting patients as they assume greater financial responsibility for their healthcare.

Patients are increasingly prepared to interact with the healthcare sector as consumers. And a more informed patient is a more educated patient, which is good for the entirety of the healthcare ecosystem. For years, health plans have been offering patients high-deductible plans and health savings accounts that allow for greater selection and choice. With initiatives like MyHealthEData, the Data Driven Patient Care Strategy and Blue Button 2.0, patients can look forward to greater transparency, which will enable them to make informed decisions regarding the management of their health and well-being.

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