On Tuesday, Representative Tom Price, President Trump’s pick for Secretary of Health and Human Services, faced his second confirmation hearing, this time before the Senate Finance Committee (previously he had gone before the Health committee). In between , Price fielded some questions that yielded insight into his thoughts on some issues that are top of mind for those working in the digital health or health IT fields including meaningful use, healthcare price transparency, telemedicine, and the Center for Medicare and Medicaid Innovation.
Early on, Price answered a question about Meaningful Use with a vague but instructive meditation on the nature of over-regulation.
“[T]he regulatory scheme is so restrictive that it’s chocking physicians, so much so that you’ve got physicians who are leaving the practice, who are leaving caring for patients,” he said. “Not because they’ve forgotten how to do it or they’ve grown tired of it, but because of the onerous nature of the regulation. Meaningful Use, for example — we’ve turned physicians into data entry clerks. And if you talk to patients, what they recognize is that when they go in to see their doctor they see the top of their head as they punch information into the computer instead of the dialogue that’s important to healthcare.”
He followed up with an assertion that the government should do more follow-up on how its policies affect working doctors.
“So a recognition of the problem is extremely important,” he continued. “A recognition of the importance of rural healthcare and then looking at the consequences of what we do as a government. Oftentimes we pass the law, we pass the rule, we think it’s the greatest thing since sliced bread, but ultimately it’s harming the individuals who are trying to provide the care. You don’t get that information unless you ask.”
Price also made a nod toward the need for a patient-centric healthcare system in comments about the importance of price transparency.
“Outcomes are important and we need to be measuring what actually makes sense from a quality standpoint and allow patients and others to see what those outcomes are,” he said. “But it’s transparency in pricing too, and we don’t have that. If you’re an individual and you want to know what a procedure costs, you can’t, and there are all kinds of reasons for that, but we have to be honest with ourselves as policy-makers that if we want to make the system patient-friendly — not insurance-friendly or government-friendly — then we would make that a priority and if I’m confirmed I hope to do so.”
Responding to a question from Senator John Thune (R-South Dakota), the sponsor of a number of telemedicine bills over the last few years, Price espoused support for healthcare innovation generally and telemedicine in particular.
“I think there are areas from a technological standpoint that we are missing the boat, especially in our rural areas and our critical access hospitals,” he said. “In every other industry out there, the information technology age has arrived and is moving across the land with rapid speed and has done so. However, it seems that in healthcare we put roadblocks up to the expansion of technology, especially in rural areas, and we ought to be incentivizing that so the patients are receiving the highest-quality care. It’s possible now in our state [Price’s home state of Georgia], if you’re an individual suspected of having a stroke and you go to a critical access hospital in a rural area, it’s possible by telemedicine to have access to one of the world’s foremost treatment specialists at the university health center. That’s improving the lives and care of patients across our state and I think there’s many things we can do that can mirror that kind of technological expansion.”
Finally, following on the theme of innovation, Price fielded some rapid-fire questions about the Center for Medicare and Medicaid Innovation, a group whose fate under Trump is something of a question mark. Asked whether he supported “CMMI delivery system reform demonstrations that have the potential to reduce spending without harming the quality of care?”, Price replied:
“The second clause is the most important one. I support making certain that we deliver care in a cost-effective manner but we absolutely must not do things that harm the quality of care being provided to patients.”
Asked to weigh in specifically on bundled payments, he said “for certain patient populations, bundled payments make a lot of sense.”
“I think what we ought to do is allow for all sorts of innovation,” Price said in his final words on the topic. “Not just in this area. There are things I’m certain that haven’t been thought up yet that would actually improve healthcare delivery in our country and we ought to be incentivizing that kind of innovation.”