Who is Seema Verma, Trump's Pick for CMS Administrator?
Trump Nominates New CMS Administrator
On November 29 President-elect Donald Trump nominated Seema Verma as Administrator of CMS. Verma is the founder, CEO and President of SVC, Inc. a healthcare consulting firm boasting widespread experience with Medicaid reform and other policy related projects in Indiana, Iowa, Kentucky, Michigan and Tennessee. A registered Republican, Verma’s work favors a conservative agenda. While her vast experience is reassuring, it’s also become a source of controversy. Verma designed the Medicaid expansion program for the state of Indiana. Originally established in 2007, the Healthy Indiana Plan (HIP) covers adults ages 19 through 64 who earn significantly below the poverty level. Under Governor Mike Pence, she reformed HIP into the Healthy Indiana Plan 2.0. HIP is mostly funded by the Affordable Care Act. The program requires that beneficiaries pay co-payments and a monthly fee to participate. Critics of the Healthy Indiana Plan 2.0 argue that the program limits access to care for the low income population it’s meant to serve due to the mandatory costs and possible lock out periods of 6 months for missing a single payment. Supporters of Verma like her because she gets the job done, known in the industry for being resourceful and persuasive. Further, the programs she architects and consults on focus on individuals maintaining a sense of personal responsibility for their healthcare.
According to their website, SVC, Inc. specializes in:
Medicaid Waiver and State Plan Amendment Development
Program Design Including Consumer Driven Health Care Programs
Development of Requests for Services and Proposals (RFS/RFP), including Medicaid Managed Care
Essential Health Benefit (EHB) Analysis & Alternative Benefit Plan (ABP) Analysis
Policy and Legislative Analysis
Survey Development and Analysis
Data Identification and Analysis
Grant and Proposal Development
Project and Grants Management
Management of Community and Stakeholder Relationship
What does this mean for your home health agency?
Donald Trump has time and again announced that he will repeal the Affordable Care Act which is expected to cover 20 million people by March 2016, including coverage through Medicaid expansion programs like the Healthy Indiana Plan. While this agenda presents a critical access to care concern for the millions of Americans covered by Obamacare, Verma seems qualified to maintain affordable health insurance for low income populations while taking the steps towards privatization promised by Trump. But how will traditional Medicare plans be affected? A Trump presidency could mean some regulatory cut backs, including work done towards Value-Based Purchasing, which you can read more about here.
2016 saw the introduction of Value-Based Purchasing which requires home health agencies get prior approval of treatment in order to be paid for final claims. Implemented in a number of states, intermediaries are having a hard time keeping up and meeting their proposed response times. VBP is one of the policy changes resulting from the Affordable Care Act. Besides a possible de-regulation effort, the home health industry doesn't seem to be on anyone's fund-cutting list. Both democrats and republicans had spoken of home care as a priority. At this point, only time will tell.