The brains behind implementing much of the Affordable Care Act's new Medicare policies, Jonathan Blum, principal deputy administrator at the Centers for Medicare & Medicaid Services, will be stepping down from his position on May 16.
The announcement came by way of an internal email via CMS Administrator Marilyn Tavenner.
"It is with mixed emotions that I let you know that our Principal Deputy Administrator, Jonathan (Jon) Blum, has decided to leave CMS to pursue new opportunities," Tavenner wrote. "Under Jon's leadership, the Medicare program has served as one of our primary drivers to shift our health care system to reward quality, care improvement, and value. The Medicare team's accomplishments are too many to list, but include developing the ACO regulations, implementing our quality framework for Medicare Advantage plans, implementing our competitive bidding program for durable medical supplies, and developing many of our value-based payment strategies."
According to CMS, Medicare per-capita cost growth has remained at the lowest sustained period under Jon's tenure, while quality of care has increased and new benefits have been added to the program. Blum has held the principal deputy position since last year August, and before that directed the Center for Medicare.
In his leadership roles at CMS, Blum has been very bullish on the potential of ACOs, as well as the future of Medicare Advantage, even as he led a pruning of the program's rates for insurers, as directed by the ACA.
"We have a much different Medicare program than we did three or four years ago, before passage of the Affordable Care Act," Blum said last October, at a conference hosted by America's Health Insurance Plans Benefits are better, quality is better, and costs are coming down."
For Medicare Advantage before the ACA, "average plan payments were 114 percent of Medicare fee-for-service overall and now is closer to 103 percent and getting down to the goal of parity," Blum said. "So we are paying lower payments to our plans compared to the average FFS; quality is increasing; there is no change in benefits, and per capita costs in Part C is essentially flat."
Even though Medicare Advantage rates are being reduced, the program is still going to grow, Blum said in early April, explaining CMS's estimates that the average MA plan would see a slight increase in payment rates over last year. "We've been pretty spot on in the past four years predicting the market and how it's grown. So we've got a pretty strong track record with these estimates."
During his tenure, Blum has overseen the regulation and payment of fee-for-service Medicare providers, which during the past few years has faced ever-increasing pressure from physician stakeholders to reform the antiquated sustainable growth rate payment formula.
On Tuesday, April 1, President Barack Obama signed the "Protecting Access to Medicare Act of 2014," HR 4302, which creates a one-year patch for the Sustainable Growth Rate (SGR) Medicare physician payment formula, to April 2015. Blum's departure follows HHS Secretary Kathleen Sebelius's resignation earlier this month. Sebelius's job will be filled by Sylvia Mathews Burwell, the director of the Office of Management and Budget, but it's not yet clear who's in the running for Blum's position.