How Seema Verma is Using Advocacy to Transform Medicare

From the very beginning of her tenure in the field of health care — both as a U.S. government official and an advocate for change — Seema Verma has had one simple goal, as she so eloquently stated in 2021: “to ensure all Americans have access to affordable care while improving or maintaining the world-class standard of quality they are used to receiving.”  

Unfortunately, the system has traditionally been burdened by a series of not-insignificant challenges. These include heavy administrative costs, rising insurance premiums, and a growing bureaucratic burden on physicians that’s led to increasing cases of burnout and early retirement. And so, to protect and preserve “Medicare and Medicaid for our most vulnerable” Americans, a cause to which she’s devoted herself, Verma has launched reform campaigns that are making a difference, both in her former official capacity and as a civilian with in-demand expertise on the matter. 

Seema Verma’s Tenure as Centers for Medicare & Medicaid Services Administrator 

While in an office, Verma was able to effect systemic changes that she has said “represent a turning point for the health care system” because, when taken together, they can “transform the healthcare system for years to come.” 

Chief among her reformative accomplishments? Under Verma’s leadership, the office brought down Medicare Advantage plan premiums to their lowest rates in 14 years. At the same time, her initiatives improved accessibility for patients, increasing the number of available plan options by a whopping 77%. 

Also, under Verma’s watch, Medicare Part D coverage for prescription drugs improved vastly, as premium costs dropped an average of 12% and, perhaps even more notably, the cost of insulin for diabetic seniors reached a maximum $35 monthly rate with at least 1,600 different plan options. 

Next on Seema Verma’s list of reforms was transparency, both when it comes to what hospitals charge and when it comes to patients’ ability to access their medical records. During her time at the Centers for Medicare & Medicaid Services, rules mandating hospital price transparency took effect, allowing patients to know exactly what they’d be charged for care prior to agreeing to treatment. At the same time, the office made it easier to access medical records digitally, meaning patients could compare treatment costs with far fewer obstacles. 

Finally, her reforms shifted payment structures to encourage fair-market competition and to incentivize outcomes over the number of procedures performed. As a result, Verma’s reforms allowed doctors to adopt a patient-first approach. At the same time, she noted that these changes “have brought us closer to a payment structure that rewards lower costs and better health outcomes.”

Making a Call for Change

Seema Verma wasn’t shy when speaking out on the need for further Medicare and Medicaid reform, recruiting others to the cause. Addressing the CMS Quality Conference in February 2020, Verma made her rallying cry to “improve the quality and affordability of health care for all Americans; drive American health care toward payment for value, not volume; and lower the rate of growth in America’s health care spending.”

Verma continued, “Just as it sets sanitary guidelines for restaurants and regulations for airline safety, the government should define essential health and safety requirements to protect consumers. Consumers should feel confident that the government is doing its part to ensure that hospitals provide safe care, that nursing homes are places where we want our loved ones to reside, that laboratory tests are accurate, and that hospice care is provided with dignity.”

To achieve these goals, Verma didn’t limit herself to speaking at conferences. She took her message to Congress, testifying regularly regarding successful reforms that had already been implemented and urging further change. All of this effort was intended to continue the transformation of Medicare. “Give patients the choice and control they want; the affordability they need; and the quality they deserve,” she expressed in 2018. 

More recently, Verma has raised a warning about the direction in which Medicare reform is currently heading. “By kicking the can down the road and leaving rising costs for future generations to handle, older adults and all Americans should expect premium increases in the years to come,” she wrote in a 2022 op-ed for The Washington Times. “There’s no such thing as a free lunch — and no substitute for a genuine, comprehensive strategy to reduce health care costs, and address health care disparities by increasing access and improving quality.” Furthermore, she called on those in charge to remember what works, writing, “We showed that the key to lower health care costs isn’t greater government control or ever more creative accounting tricks; it’s the interlocking strategies of market competition, unleashing innovation, and empowering patients.

Of course, Verma acknowledges that affecting a true Medicare transformation requires “the hard work of advancing sustainable, long-term reforms to modernize American health care and bend the cost curve down.” However, she’s not one to back down from a challenge. And she’s in it for the long haul because, as she concludes, “It’s not easy, but we’ve shown it can be done.”

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