Reinventing CMS in Alignment with the Objectives of

Reinventing CMS in Alignment with the Objectives of the ACA Lila & Roxane Contemporary Issues in Public Administration August 2014

What is the ACA? PPACA law signed March 23, 2010 Medical insurance access & affordability Goal: 94% of U. S. Citizens Method: Health Insurance Marketplaces Open enrollment started October 2013

What is CMS? Largest division of HHS Oversees ACA Federal vs. State

CMS Reinvention: Clarity of Purpose Objective: “Creating Clarity of Role by Separating Steering and Rowing” (Osborne and Plastrik, 2000). Missed Opportunity: Health Insurance Marketplace Leadership, CMS missed opportunity to designate a market place leader. No accountability.

CMS Reinvention: Consequence Strategy Objective: The Centers for Medicare & Medicaid Services' strategic objective for Medicaid is to ensure access to quality, culturally competent care for vulnerable populations (HHS Federal, 2013, para. 8). Missed Opportunity: Medicaid expansions with marketplace extentions, resources, State control.

CMS REINVENTION: Customer Strategy Objective: “Making customers powerful through Choice and Competition” (Osborne and Plastrik, 2000). Missed Opportunity: CMS missed their goal as it failed to provide the American public the choice of incentives. Personal health choice, lowering prices.

Next Steps of Action: Our Recommendations Appoint strong Marketplace leader Increase Medicaid expansions with extenstion, resources, State control Initiate health incentive voucher program