Slavitt: ‘We’ll Go as Fast as the Evidence Allows Us to Go’

Acting CMS Administrator Andy Slavitt has a lot of explaining to do. And a lot of listening. In recent months, the agency issued draft rules carrying out what's intended to bring transformational change to the way Medicare pays physicians. It also rolled out a slew of experiments with payment and delivery reforms, including its first mandatory demonstration programs. In the process, Slavitt has become highly visible on social media and in person, and he has developed a reputation for unusual candor in conversations with healthcare leaders and clinicians. Slavitt spoke last week with Modern Healthcare managing editor Gregg Blesch. This is an edited transcript. 

Modern Healthcare: Are we seeing so much come out of the CMS now because your time is running out?

Andy Slavitt: We'll be working on Jan. 20, and one of the things I feel really good about is I'll have virtually my entire team still in place, because there is a lot of important work and everyone's really excited about it. And it is work we're executing hand in hand with hospitals, physicians and others. Having said that, it's not my intention to drop a bunch of stuff off at the end of this administration and leave. It's to create a launching pad for whoever comes next so that we've planted the appropriate seeds in the appropriate lanes. For example, in our cardiac work we did a medical bundle for (myocardial infarction), which is an innovation. That's an example of not just feeling the market was ready and it was the right thing to do, but also leaving tracks that others can follow. 

MH: But do you feel extra motivated by a sense that another administration might pull the plug on some of this work and the Innovation Center? 

Slavitt: The Innovation Center has demonstrated to be a saver. As a result, I think it's become an important, permanent part of the infrastructure. They have a lot of work to do, so I think they're motivated, and I'm motivated, by the moment and the inflection point. We're always going to be going a little too slow for some and a little too fast for others. If we get it right, we'll be giving opportunities for some to move fast, and that will move the market faster than anything else. And if we move smart, we'll also be creating carve-outs for rural practices and rural hospitals and things like that so we don't overwhelm areas.