CMS’ biggest health care accomplishments in 2023 (and key initiatives for 2024)

President Joe Biden is scheduled to deliver his annual State of the Union address to Congress in March. In January, the Centers for Medicare & Medicaid Services’ Administrator Chiquita Brooks-LaSure updated stakeholders on the state of the agency in what was a momentous year in health care.

Record enrollment

“You helped 160 million people connect to affordable, comprehensive and affordable care, and that’s worth celebrating,” Brooks-LaSure said during a national stakeholder call. “First, we made historic strides in making heath care affordable. It’s one of the Biden-Harris administration’s top priorities to help people afford the health care they need to thrive. Thanks to those investments, health-care coverage is now more affordable and more accessible than ever.”

Enrollment through the federal Marketplaces set a record for the third consecutive year, with more than 20 million people signing up. Each number represents a person needing health care, Brooks-LaSure said. “More importantly, a record number of people now have access to affordable, comprehensive health-care coverage,” she said. “They are finding plans for truly affordable premiums and copays.”

Prescription drug costs

Administration efforts to make prescription drugs more affordable were a key focus in 2023.

“Through the Inflation Reduction Act, we are delivering meaningful savings to people with Medicare,” Brooks-LaSure said. “Thanks to the law’s landmark reforms, we already are lowering costs through free recommended vaccines and caps on insulin costs. And for the first time in history, drug companies can’t hike their prices above the rate of inflation without having to pay a rebate to Medicare.”

Last August, CMS announced that Medicare will be able to negotiate directly with manufacturers to improve access to some of the costliest Medicare Part B and Part D drugs. Negotiations will continue this year and become effective in 2026. The Congressional Budget Office estimates that price negotiations will reduce the budget deficit by $25 billion in 2031.

“Medicare now has the authority to directly negotiate lower drug prices for conditions such as cardiovascular disease, diabetes, Crohn’s disease and rheumatoid arthritis,” she said. “People on Medicare have a cap on their out-of-pocket prescription drug costs. Affordability will always be a guiding light in our work together.”

Maternity care, behavioral health

Maternity care has been another focus, and access through both Medicare and the Children’s Health Insurance Plan has been expanded. Now, 43 states, the District of Columbia and the Virgin Islands provide postpartum coverage for up to 12 months.

The pandemic shined a spotlight on behavioral health issues, and Medicare now covers marriage and family therapy.

“The CMS Innovation Center just launched a model to improve the quality of care and outcomes for Medicare and Medicaid enrollees with moderate to severe behavioral health conditions, including substance use disorders,” Brooks LaSure said. “I am especially excited to announce that as of last week, more than 11,000 mental health counselors and more than 1,700 marriage and family therapists already have enrolled in Medicare to provide these vital services.”

Provider burnout

Although CMS is focused on the health care of enrollees, it also seeks ways to ease the burden on providers and other health-care workers.

“We are working to reduce the stress on doctors and nurses, which contributes to provider burnout and prevents people from getting the care they need,” she said. “We just finalized our policies to reduce unnecessary administrative burdens, such as challenges with the prior authorization process. It is critical that prior authorization not be an impediment to people getting care but to improve their care.”

Health equity

Health equity continues to be a core value for the agency.

“Equity will always be a cornerstone for our programs and initiatives by focusing on getting everyone eligible for coverage and ensuring that when they get into coverage that is meaningful, that children get their vaccines and mental health services, that young adults get preventive and primary care, and that seniors can afford their prescription drugs and care in the most appropriate setting,” Brooks LaSure said.

Related: CMS’ Innovative Behavioral Health model for states: New approach to mental health care

With presidential and congressional elections looming, it remains to be seen whether this year will be as productive as the last one, but she is committed to moving her agency’s priorities forward.

“2023 was nothing short of extraordinary,” Brooks-LaSure said. “We have an ambitious agenda for 2024. All of our work is focused on working to ensure that all of the people covered under our programs have an opportunity to obtain their optimal health, no matter what they look like, where they live or how much money they have.”