Issue link: https://beckershealthcare.uberflip.com/i/821337
108 THOUGHT LEADERSHIP Andy Slavitt: Hospital CEOs Must Leave the Sidelines, Join Conversation on Health Reform By Emily Rappleye A fter two years as CMS acting administrator, Andy Slavitt plans to spend his new- found time helping collaboration between lawmakers on the Hill and healthcare providers in the private sector. Since leaving CMS in January, Mr. Slavitt has signed on at Avia, a Chi- cago-based network of health sys- tems using digital technology to drive innovation, and as a senior policy advisor at Biparti- san Policy Center, a nonprofit Washington, D.C.-based think tank. Prior to CMS, Mr. Slavitt worked in the private sector, most recently as the group executive vice president of Unit- edHealth Group's Optum unit. Becker's caught up with Mr. Slavitt in April to discuss how his experience at CMS is driving his post-administration plans and his views on healthcare policy under the Trump administration. Editor's note: Responses are edited lightly for length and clarity. Question: Due to the instability in Washington, D.C., many hospital leaders are taking a cautious approach to strategy and dialing back their investments. Do you think this is wise? Andy Slavitt: What the administration needs to under- stand, particularly because it is so focused on jobs, is one- sixth of the economy cannot easily adjust to long periods of indecision without cutting capital and reducing hiring. Because turnover is so high in healthcare, it's not hard for hiring to slow down or capital spending to slow down and for that to really impact the economy, particularly in small- er, rural communities where a lot of hospitals are located. Washington would be wise to wake up to this fact and pro- vide some clarity and some timetables and not leave an open-ended negotiation going for too long. Q: What would your advice to hospital leaders be right now? AS: Hospital leaders need to start with this: Whatever hap- pens in health policy, or otherwise, focusing on improving patient care, focusing on how to take care of the most dif- ficult to treat and neediest people in the community, will always be beneficial. In my mind, those are important in- vestment areas. Secondly, innovating in ways, as I think Avia has shown, that can keep people healthy, keep physicians fulfilled, keep consumers engaged and reduce medical costs are always going to be good investments. Third, it's a perfect time to get engaged in the policy con- versation directly. We have a CEO-president who is going to value input from people who are job creators. I think people are too frightened of the Trump administration and many are too far on the sidelines. The CEOs I've talked to who have engaged with the Trump administration find they can get listened to, but too many are unwilling to speak out as directly as they should. Q: You're joining Avia and planning to serve as a senior advisor at the Bipartisan Policy Center. What will that work entail? AS: On one hand, I would say my contribution hopefully to Avia will be no matter what happens in Washington, [to help] people do things differently. We are not going to be successful if we don't innovate. My interest was to find the best platform to not just see new innovations in healthcare — because quite honestly, that's not our problem; there are plenty of innovations. The challenge is how do we scale those innovations across really big healthcare systems, communities and the country. What I admire about Avia is they took big pressing challenges, like clinician burnout or post-discharge success, and they brought an approach to it that said, 'How do we find the best innovations and scale them across multiple delivery systems in a way that cultural- ly works?' In my opinion, it's a very unique approach. For the Bipartisan Policy Center, I want a forum where the real world needs of the healthcare system can interact in a credible way with policymakers. BPC is a great forum for governors, CEOs, lawmakers and patient advocates to have trusted conversations that put the politics to the side and focus on how to make the system work better. Q: I know CMS was especially careful in designing the Medicare Access and CHIP Reauthorization Act rollout. Now that you've stepped back from your role at CMS, how do you feel the MACRA implementation is going? What is going well and what concerns you? AS: We need to pay as much attention to implementation as we do to laws themselves. I arrived at CMS to help lead the turnaround of HealthCare.gov, precisely because it was very good policy, but there was not as much focus on im- plementation and operations. Public policy isn't that differ- ent than business. I believe in the adage that it's 90 percent about implementation. In the case of MACRA, what we are really trying to do is help physicians, many of whom are in places where they have never participated in pay-for-value programs before, who don't have a lot of office resources, who may be small or in rural locations, and can't just have a bunch of programs heaped on them, particularly on top of everything else they do every day, and be expected to work. I would urge the people involved in [MACRA] to look at it as a five- to 10-year process of success, not a one-, two-, three-