'The One-Size-Fits-All Model Is Awful': Kat Cammack Demands Reforms To Medicare Programs

Hinzugefügt: 2026-05-30

[00:00:03]The gentleman yields. The chairwoman recognizes herself for 5 minutes.

[00:00:09]All right. Well, thank you all for being here. Not just our witnesses, but all of our our folks in the gallery today. Um, you know, too often and I think you've heard this today on both sides of the aisle, we say that we have a healthcare system, but what we really have is a sick care system that is wrapped in layers and layers of paperwork and bureaucracy.

[00:00:28]For years, Washington has promised physicians that if they just fill out a few more forms, track a few more metrics, and jump through a few more compliance hoops, that quality would improve and costs would come down. Now, we all know that that is a load of BS.

[00:00:42]So, we find ourselves where doctors are still buried in documentation, patients are still struggling to access care, and independent practices are disappearing.

[00:00:52]Somehow, the answer always seems to be that more reporting requirements and more administrative complexity is the key.

[00:00:59]At some point, we need to stop confusing more paperwork with better healthcare.

[00:01:07]Physicians should, and I believe want, to be focused on keeping their patients healthy and practicing medicine, not spending half their day trying to satisfy another scoring system designed by bureaucrats in Washington, typically a bunch of people who aren't MDs.

[00:01:24]So, I'm going to start with you, Dr. Dr. Furr, is that how you say it? All right, I'm terrible with names, so bear with me on this one. I think a lot of physicians feel that they're spending more and more time navigating the system, as I just said.

[00:01:35]They're not treating patients, instead, they're doing uh the the administrative work, and they could say that maybe some of that is um MIPS, which for folks watching back home, that is the Merit-based Incentive Payment System, and dealing with reporting requirements, but it's also some of the billing documentation, prior authorizations, compliance reviews, liability concerns, that are all piling on top of each other. So, here we are nearly a decade after MACRA. What changes would actually help physicians that this body could take on that would spend keep those doctors spending more time with patients and less time doing data entry?

[00:02:10]Well, thank you. If you actually looked at primary care and actually did something like a per member per month reimbursement to take care of the patient and manage the patient, uh so that you would have the money to invest in the technology and staff that you need and then incentivize them to take care of that patient and manage them over time rather than just their acute illnesses. That's been done before with HMOs and others and has been very effective. Uh and then you would be focused on managing the patient and not just managing the metrics.

[00:02:37]You know, sometimes I tell a patient, "You might be having a heart attack while I'm sitting here, but I'm going to make sure I got all your numbers right."

[00:02:42]So, you know, you got to focus on the patient that's there before you.

[00:02:45]It's almost like we should prioritize patient outcomes rather than metrics?

[00:02:49]Yes.

[00:02:50]Novel idea. I'm going to pivot to you.

[00:02:53]I'm going to butcher this, but I'm going to try. Dr. Masashari? You got it. Yes. All right.

[00:03:00]Well, you noted in your testimony that MIPS has not really worked the way that Congress has intended under MACRA. So, how can Congress simplify this in a way that actually is reducing the administrative burden? Give me a real tangible item that we can undertake here on this committee. Yes.

[00:03:15]One one point first on your first question, a lot of the paperwork that's put in place, the prior authorizations, the denials, the the the utilization management, the narrow networks that people are sick and tired of, those are all attempts at cost containment in a fee-for-service And Doc, I'm up against the clock. We can all agree that the insurance people are horrible. So, let's get to my point let's get to my question. My my my point is just in a value-based care model where you don't have the incentives aligned incentives to do more, you don't have to worry about those things. And so, things like the per patient per member funding becomes more more more feasible. Um in terms of the specifics on on MIPS 1, the efficiency measure, the cost measures should be taken directly from the Medicare Shared Savings Program ACOs. Quality measures should come out of any system, not just the electronic health record, and we should have a mandatory standardized set of quality measures for every one of the types of specialties, including primary care, not a pick-your-own adventure, so that the measures can actually be relied upon. Perfect. Thank you. And I'm going to turn to you, Dr. Smethurst.

[00:04:28]Heck, yeah. Your testimony also highlights concerns with how MIPS applies to radiology and other specialty providers, especially when it comes to reporting and the one-size-fits-all metrics. Anybody who knows me knows that I think the one-size-fits-all model is awful. So, talk to me about the reforms that you would implement to make these programs more clinically relevant and less burdensome for our specialists.

[00:04:51]Well, I think that for radiologists who are involved at different points of the patient's care journey, but really don't control the whole outcomes, having things that are specialty specific, that really apply to the work that we do and the quality of that work would be incredibly helpful and much more meaningful than the one-size-fits-all model we have today. Excellent. I went exactly 5 seconds over my time.