On October 1st CMS set off a wake-up alarm for our country.
The alarm rang for every person in the US. Yes, everyone – no matter your place in the health ecosystem: patient, provider, HealthTech company, caregiver, payer, insurer, researcher. All of us.
The impact of the 2030 CMS goal – accountable care for all beneficiaries – is already being absorbed into the traditional medical insurance model.
Value has become a constant element of every health plan’s messaging and delivery.
And, frankly, don’t we all need more value for our healthcare spending?
Because, for possibly the first time in our generation, no one is escaping the impact of rising health care costs.
The Link Between AI and Value Based Care
Maybe this is the first you hear of this link … enabling AI to improve the value of the daily delivery of patient care is linked to the CMS goal for 100 percent of beneficiaries in accountable care by 2030.
Now that’s an interesting link. How is it made?
First part: the three key ingredients CMS identifies in the adoption of accountable care by 2030.
- Educate the patient and the provider / care team
- Regulatory flexibility – make adjustments, where needed, to support adoption
- Enforce data interoperability – legislated by The Cures Act to eliminate data blocking by Actors
The last point, data interoperability, is the trailer hitch (so to speak) that Actors who retain patient data are required to hook on.
Second part: we know that AI consumes data. To assist patient care, AI requires a lot of patient information that is complete and timely. The more the better.
The Cures Act is the link; it ensures the flow of patient data in the delivery of care and to feed the AI machinery.
AI is fueled when blocking health data is eliminated.
Was AI considered on December 13, 2016 when former President Obama signed The Cures Act legislation to eliminate data blocking? Unknown.
But … it does seem a bit crystal ball-ish considering where we are today: five years from the end of a fourteen year runway.
The advancement of AI will be better / faster delivered with the help of increased access to patient care data that simultaneously supports the delivery of value base care.
Today’s View of The CMS 2030 Goal
Three noteworthy and recent value based care happenings:
#1 – The October 1 CMS email announcement – on the first day of the government’s Fiscal Year 2025 – clearly is an alarm clock that restates the 2021 CMS Innovation Center Strategy Refresh
The email included a comprehensive 2,103 word article reiterating CMS’s commitment to delivering accountable care in the next five years to all Medicare and Medicaid beneficiaries.
If you are not a beneficiary, I am certain you have a close relationship with at least one.
In 2024 there are 60.6 million people enrolled in Medicare Parts A and B. In June 2024 there were 79.9 million individuals enrolled in Medicaid and CHIP.
As it’s been said, look to your left, look to your right…
We are all impacted by the CMS 2030 accountable care goal and access to patient data – to support the daily delivery of care – is a crucial part of the strategy.
Click on the headline below to read the CMS article. It’s a hefty reminder of where CMS is taking our nation’s health care.
#2 – Three new executive government positions, including the Office of the Chief AI Officer, are being filled by the ASTP/ONC. Here is the CMS video explaining the three new roles.
#3 – The past few weeks were quite busy for HHS, including hosting Federal Health Innovation Day presentations across the U.S. to highlight innovation by ASTP/ONC, VHA, and the CDC. I attended the Nashville event where many of the local healthcare executives focused many questions and comments on AI.
News reports indicate Mickey Tripathi “is everywhere” talking about his new elevated role as the Assistant Secretary for Technology Policy, National Coordinator for Health Information Technology, and Chief Artificial Intelligence Officer (Acting) [emphasis mine].
His new role has expanded Federal Government technology responsibilities as the need to fill the three new executive positions with the best candidates for the next five-year journey.
Is This Really Happening
Let’s wrap it up with a clip taken from the CMS Innovation Center Strategy Refresh published in 2021 – three years ago.
Figure 4 in that document is a timeline (clip below) that still rings true. Since that time The Cures Act data blocking legislation came into full effect to support (i.e. enforce) the progress.
From Figure 4 of CMS Innovation Strategy Refresh (2021)
Accountable care is a program set in place in 2016 with a fourteen year ramp up. You can bet that plan will not veer significantly in the next five years.
The goal is within our reach.
Your Role in Patient Care
From the OIG website: Anyone who believes they may have experienced or observed information blocking by any health care provider, health IT developer of certified health IT, or health information network or health information exchange is encouraged to share their concerns through the Information Blocking Portal on ONC’s website, HealthIT.gov.
Are you using a ⭐ ⭐ ⭐ ⭐ ⭐ health app as a patient or caregiver?
As a provider or tech company have you established interoperability that improves patient care?
Whether you are personally invested (at some point we are each a patient), a caregiver, or professionally engaged (healthcare is 17.3% of the GDP) staying informed about emerging patient technologies is crucial, and interesting.
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After all, it’s all about We The Patients, right?
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