“This is my show, and I’m not going anywhere.” This could have been what Dr. Oz said on stage this week when he spoke at this week’s ACCESS Model event: “Building a Healthier America.” Instead, it is a line from the easily forgotten movie Late Night, despite Emma Thompson doing her usual fantastic and totally hilarious acting job. This is the movie that came to mind as I was listening to a packed 2-hour show about the expansion of the ACCESS payment model. If you don’t know, Original Medicare (through the ACCESS model experiment) will now also pay for tech-supported management of heart failure, COPD, substance use disorders, and tobacco cessation beginning in the Spring 2027. In the One Thoughtful Paragraph, I will explain why the Late Night movie theme of “it may be a show, but there are people depending on it” fits our current situation.
The following news items are not funny. I explain why I cannot find any levity here:
- HHS Deputy Secretary nominee Chris Klomp testified before the U.S. Senate Finance and U.S. Senate Health, Education, Labor and Pensions Committees (here, here) during his confirmation hearings this week. Klomp was asked about his involvement in the Trump administration’s most-favored nation drug pricing deals, vaccine safety, and staffing issues. It is not funny that (arguably) the most powerful leader of HHS was not asked about the agency’s vision for technology changing the health care system. Why wasn’t there a whole line of questioning about the use of AI in our health care system? That’s not just unfunny, it ignores one of the single most important issues right now.
- There is disagreement about whether virtual chronic kidney disease management products slow disease progression (compared to traditional care) or reduce health care spending. A new Peterson Health Technology Institute assessment concludes that they are not that helpful, and the companies that do this type of work disagree. There is nothing funny about chronic kidney disease, and it is even less funny if our solutions aren’t working as well as we’d like.
- At the CTA Health AI+ conference last week, the fearless leader of the ONC (Dr. Tom Keane) reportedly noted that the HTI-5 proposed rule, currently under review with provisions that would overhaul the ONC health IT certification criteria for EMR software, is expected to be finalized very soon. The “Office of No Christmas” seems ready to ruin our planned fall foliage-seeing trips in addition to messing with major holiday breaks. There is nothing funny about taking people away from their much-needed nature moments, Tom.
“Don’t take this the wrong way, but your earnestness can be very hard to be around.” I feel like every major policy player in D.C. could say this to the CMS leaders who spoke at the ACCESS Model event this week. But it is actually a line spoken by the great Emma Thompson from Late Night, a comedy-drama about a popular TV host who hires a writer to keep her show from getting booted off the air (hello, Stephen Colbert). Now, we all know that CMS Administrator Dr. Oz used to have a tv show, and he talked about it at the ACCESS event. He said that – just like when he’s talking to a large TV show audience – he has to be exceptionally clear in his messaging to be effective enough for 7,000 CMS employees to understand the big goal. For this week’s show about the ACCESS Model expansion, Dr. Oz said that the big goal is a “deliberate move away from micromanaging clinicians to paying for results.” Sure, and some past administrations would call that “value-based care.” But I found it interesting that he drew from his physician experience when he said that technology-based tools have the benefit of nudges (e.g., sleep, medication reminders) for when a patient is actually receptive to them, rather than a rushed, in-office clinical visit. So Dr. Oz’s earnestness seems to be a result of drawing from both his physician and TV show experience to this big CMS job. It is like how the new writer explains to Emma Thompson about how to keep her Late Night show on the air: “This is your show, and it is an expression of who you are.”
