Trump, as a businessman, may support CMMI for its innovation, analyst hopes
Athenahealth CEO Jonathan Bush and consultant Paul Keckley both think Trump's desire to run the country as a businessman bodes well for innovation.
Athenahealth CEO Jonathan Bush
President-elect Donald Trump has made clear his intention to repeal and replace the Affordable Care Act, but what this means for value-based innovation is still unclear.
While some Republicans have reportedly expressed a wish to financially gut the Centers for Medicare and Medicaid Services Innovation Center, and providers have complained of the pace and burden of some of its volume to value initiatives, healthcare consultant Paul Keckley says he believes the businessman in Trump would be eager to keep it going.
CMMI was established by the ACA to try things to see what works, he said.
"CMMI is what a business person would do," Keckley said.
[Also: MACRA will move forward largely untouched when Trump steps in, experts say]
CMS Acting Administrator Andy Slavitt said in a tweet Thursday that CMMI is needed.
CMS will continue to implement reforms such as MACRA, until ordered not to, Keckley said. Going back to the former method of the sustainable growth rate formula would cost about $140 billion, according to Keckley.
Keckley said he talked with a group of 14 major health system CEOs the day after the election on Wednesday.
"I think there's uncertainty," he said. "There was a fair amount of skepticism about ACOs and mandated bundles. … I don't think we're going to have clarity in the near term."
Athenahealth CEO Jonathan Bush, often outspoken about healthcare regulations, also weighed in.
[Also: Analyst: Trump, GOP control could mean fast-track for legislation to help rural hospitals]
"While federal mandates of past administrations will carry over into Trump's term, the energy it will take to rewind and unwind what is in place -- whether it be Obamacare or MACRA -- will likely result in chaos and gridlock within the government as it's determined what is, and isn't, 'repealable.' Given that, we believe it is highly unlikely healthcare will see any swift changes in the short-term."
CMS may see a purging of activities promising to deliver value and a sharper focus going forward on projects that manage costs more effectively, Keckley said.
"He wants to bring this business view of government," Keckley said. "Where he'll run into challenges is in how Washington works."
Keckley said he believes Trump will differ with House Speaker Paul Ryan, R-Wisconsin, on the replacement plan for the ACA because Ryan's plan was cooked up by Washington insiders and Trump ran on a platform of cleaning up the swamp.
"I think CMMI passes the smell test," Keckley said. "The message he's going to send is, he's the CEO, I wrote 'The Art of the Deal."
Trump may also run into difficulty with Ryan on Medicare, according to The Washington Post. Ryan told the Post Thursday that the entitlement program has serious problems and needs to be addressed at the same time Congress repeals and replaces Obamacare.
Names under consideration for Health and Human Services secretary include former Louisiana Republican Gov. Bobby Jindal, former Republican presidential candidate Ben Carson, former House Speaker Newt Gingrich, Gov. Rick Scott, R-Florida, former Rep. Renee Ellmers R-North Carolina and former Utah governor, Mike Leavitt.
Keckley said he thinks Trump will appoint a governor to manage the department.
"The reason to put a governor into HHS, it immediately sends the message we're running this like a CEO," he said.
Twitter: @SusanJMorse
