Q&A: Former CMS official thinks outside 'black box'

HARTFORD, Conn. - Leslie Norwalk is a former CMS acting administrator, but these days, in her role on CareCentrix's board of directors, she loves being closer to the provider side of things.

“CMS is often seen as a big, black box,” she said. “I think it's important to demystify that government agency and help providers understand how regulators think.”

Here's what Norwalk, strategic counsel to Epstein Becker Green, had to say about why the Department of Health and Human Services and CMS are more willing to flex their regulatory muscles to embrace big data and technology.

HME News: What does your background bring to the table?

Leslie Norwalk: I like to consider the future of what the U.S. healthcare system can be and the impediments to getting there. I help companies like CareCentrix how to navigate Medicare and Medicaid requirements, and how to innovate within the requirements or work with regulators to update the requirements for the quickly changing healthcare environment, to provide higher quality care at a lower cost.

HME: How have you seen health care change since your time at CMS?

Norwalk: Health care is on the cusp of dramatic change, but the pieces are just starting to come together. And just in time. Employers are growing increasingly frustrated with current healthcare benefit designs. I think the data that are available, and the information that we can glean from that data to really target the best approaches for patients, is rapidly coming to market in many forms. A paradigm shift is needed in proving care, and big data provides the ability to make difference in a way that hasn't been seen before. Other changes will be required to take advantage of this ability, and the good news is that HHS seems willing to consider what might be needed on the regulatory side.

HME: Do you believe it's truly possible to create patient-centered care, when there is so much focus on cutting
reimbursement?

Norwalk: Of course. Providing the right care for the right patient based on data eliminates a sufficient amount of waste in the system. Better to pay for high-quality care than to pay for unnecessary hospital visits and or other complications that add costs to the system, due to substandard care.

HME: What do you think are some of the biggest challenges or innovations in patient-centered, in-home care?

Norwalk: Often challenges and opportunities go together. More and more, technology and other types of innovation allow patients to be treated at home, whereas before they had to be in a skilled nursing or other inpatient facility. But the success of home care often depends on things outside of the traditional healthcare system. These social determinants of health are rapidly being recognized as an important part of the success (or failure) of treating patients at home. Treating healthcare problems in a more holistic fashion can increase the likelihood that impediments to a patient's wellbeing can be removed and the results of care at home be maximized.