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July 25, 2019

The White House's 3 top health care priorities

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    HHS Secretary Alex Azar on Tuesday laid out three of the Trump administration's health care priorities heading into the 2020 election.

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    Azar commented on the administration's health care priorities during an interview with "Pulse," as well as during a speech Tuesday at the Better Medicare Alliance's summit.

    Azar said the administration's three top health care priorities will be to:

    1. Bolster public health;
    2. Change how health care is financed; and
    3. Improve the value of health care.

    Azar said the priorities represent the administration's "unified theory of heath care."

    1. Bolster public health

    Azar said the administration already has worked to improve public health, noting President Trump's recent executive order aimed at overhauling the kidney care and donation allocation process in the United States and the administration's proposal to eradicate HIV transmission in the country. Azar also suggested that the administration could use payment models to address the country's high maternal mortality rates, social determinants of health, and access to health care in rural areas.

    Azar said, "We need to protect our mothers, and that starts by developing a comprehensive strategy that improves payment incentives, boosts adoption of best practices, and addresses preventable risks."

    In addition, he said, "Rural access to care can be a huge challenge … [b]ut [the administration] believe[s it] can design new ways to sustainably finance care in these areas, supporting innovation and providing flexibility to meet these communities' health needs."

    Further, Azar said the administration could use Medicare Advantage (MA) payment models to address social determinants of health. "You've already seen one effort to address this through new supplemental benefits in [MA], like home-delivered meals, transportation and home modifications. We want to go further," he said.

    2. Change how health care is financed

    Azar said the administration also already has taken actions to improve the way health care is financed in the United States, including defending proposals to tighten Medicaid's eligibility requirements.

    Relatedly, Azar said the administration would continue to oppose proposals to implement a single-payer health care system.

    3. Improve the value of health care

    In addition, Azar said the administration has been working to improve the value of health care, and cited administration's drug pricing proposals, as well as Trump's executive order on health care price transparency, as examples of those efforts. He said, "Under the executive order, hospitals would have to disclose information about their negotiated rates in a public format that is understandable and usable for patients. Insurance companies will be required to provide patients with information about out-of-pocket costs before they receive services, rather than weeks later when they get the bill. Surprise bills will be a thing of the past."

    Azar did not provide details on when HHS plans to release regulations under the executive order.

    Azar also said the administration could look to improve "value through payments in [MA], where we want to open up more opportunities for [MA] plans and entities they work with, including creative value-based insurance design arrangements, moving care to the home and community, and new ways for [MA] plans to improve a patients' health over the long term." For example, the administration could use the five value-based payment models CMS introduced in April to shift primary care providers and other eligible professionals from fee-for-service payments to value-based payments, Azar said (Diamond, "Pulse," Politico, 7/23; Luthi, "Transformation Hub," Modern Healthcare, 7/23).

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