CMS Administrator Seema Verma, MPH, and Cleveland Clinic CEO Toby Cosgrove agreed change is needed within the healthcare industry. Where they disagreed is the level of change that should be dictated at the state level.

Speaking at a panel at the Clinic’s Medical Innovation Summit, Verma called some federal healthcare regulations “overly burdensome,” and said states should take the lead rather than CMS or HHS.

“We’re not gonna tell states what their priorities are—they’re gonna come and tell us what their priorities are and it’s our job to help them get there," she said.

Cosgrove—who opposed the Affordable Care Act (ACA) repeal-and-replace bills that involved greater state input on insurance regulations and Medicaid funding—said he welcomes more flexibility “out of Washington,” but wants experimentation so the industry can figure out the best practices under value-based care and then apply them nationwide.

“I think one thing we have to be careful of is we don’t want 50 different healthcare programs across the country,” he said.

The two agreed on many other aspects of policy, such as the need for interoperability, greater price transparency and finding ways to lower costs.

Cosgrove said “almost everybody agrees” value-based care is the direction the industry needs to go, but added that getting it done quickly will be difficult and require a “total restructuring” of care delivery across the country.

“I think as we do that, we're going to see the quality improve; we're going to see the costs come down,” he said. “This is an enormous transition.”

The summit will be Cosgrove’s last as Cleveland Clinic’s CEO. He’ll be stepping down at the end of the year to make way for new CEO Tomislav Mihaljevic, MD, with Cosgrove remaining involved in the system in an advisory role.