Nimble payment models

Nominated for the position of administrator of the Centers for Medicare & Medicaid Services (CMS) by the president in 2007, Kerry Weems, a finance and budget expert, was never officially confirmed. Even so, as acting administrator for more than a year, Weems launched e-prescribing programs, electronic health record pilots, the nursing home quality-comparison Web site, and the CMS do-not-pay list for egregious medical errors.

The confirmation process for such an official typically includes some partisan wrangling on the Senate floor. With a long list of sensitive healthcare issues under examination-including the debate over the expansion of the State Children's Health Insurance Program (SCHIP) in the summer of 2007-Democratic senators were unwilling to confirm a top healthcare leader nominated by the Bush administration.

Weems was a respected official who was adept at keeping Medicare and Medicaid running efficiently. Not being confirmed was a limiting factor in promoting controversial programs and policies, but he did follow through on the promise he made in his nomination testimony to intensify CMS oversight. He was particularly driven to wring fraudulent activities out of the Medicare and Medicaid payment system.

Now retired from government, Weems continues to influence healthcare's evolution as the senior vice president and general manager for health solutions with global consulting firm Vangent Inc. He remains an advocate of interoperable health records, fraud prevention, comparative effectiveness, value-based purchasing and quality reporting.

"When you leave government after 28 years, you have these notions of what you might want to do," he says. "It really took an entire six or seven month period for me to shed my government skin and decide what I wanted was to work in a health practice and continue moving healthcare in America along to higher quality and lower cost."

The major policy issues haven't changed much since Weems left government. He recently sat down with MHE to assess a few of the industry's biggest challenges.