Dr. Mehmet Oz appears to have passed his Senate testimony with flying colors, and the surgeon-turned-TV-personality’s confirmation as CMS administrator seems all but locked in.
The nearly three hour testimony wandered through a range of topics with a direct impact on digital health, giving us a first look at what might change – or get axed – in the years ahead.
- Prior auth topped the hit list. The most concrete policy idea that Oz offered was limiting the number of procedures subject to prior auth in Medicare Advantage to 1,000, a steep reduction from ~15,000 today. Oz said the “pre-approval process is expensive and wastes time,” especially when we have AI that can “pretty quickly adjudicate whether you should have to wait even a day to have the medication that will get you out of pain.”
- AI was a major theme throughout the testimony. Oz plans to use AI to help doctors “optimize care” and focus on their patients, making several references to its ability to augment treatments and cut down on paperwork. He also said “we should be using AI within the agency to identify [fraud] early enough so that we can prevent it.”
- Medicare Advantage was another big focal point. Oz cited MedPAC research showing that MA is more expensive than traditional Medicare, but attributed much of the cost to upcoding from payors. He promised to hit the problem head-on with an AI hammer.
- Medicaid was a mixed bag. While Oz said he fully supports the program, he also agreed that spending has gone off the rails since the ACA, and was in favor of implementing work requirements. Oz sidestepped questions about potential cuts by saying “the way you protect Medicaid is by making sure that it’s viable at every level,” which includes having enough practitioners, compensating them fairly, and improving patient access.
The Takeaway
It’s hard to take the other side when a charismatic doctor vows to fix a broken healthcare system, but it’s also tough to tell the difference between empty promises and real reform until action backs it up. Part of that will have to wait until the actual confirmation, but as Oz put it, “part of this is just recognizing there is a new sheriff in town.”
