If confirmed, HHS secretary nominee Alex Azar plans to take on EHRs, care delivery reforms

Though much of the discussion during Alex Azar's confirmation hearing for secretary of the Department of Health and Human Services centered on his ties to the pharmaceutical industry, a Senate panel also grilled Azar on payment reforms, the Affordable Care Act and electronic health records. 

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Alex Azar

If confirmed, Azar told the Senate Health, Education, Labor and Pensions Committee that he'd want to delve into the regulations and the role that EHRs plays to contribute to the administrative burdens that are at the top of physicians' complaints.

In an exchange with Sen. Lamar Alexander, R-Tenn., who chairs the committee, he agreed that there are steps that lawmakers can take to ease the burden on providers.  

Azar said he would solicit responses from physicians and providers on what they need to make EHRs easier to use. 

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Sen. Bill Cassidy, R-La., said that EHRs are pushing more physicians to retire early, and asked if Azar has ideas that would take advantage of health IT in a way that improves the physician-patient relationship. 

Azar said the key was interoperability, and that to make EHRs more effective and less burdensome they need to be expanded in tandem with increased interoperability. 

Azar has been critical of the ACA, and Democratic senators questioned his position on efforts to repeal and replace the law and changes made to open enrollment under the Trump administration. 

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Azar said that he would execute the law as required should it stay in place, but that he agrees with lawmakers who want to make significant changes to it. The former pharmaceutical executive said that he has the same goals as Democrats who support the ACA—lower costs and increased access to care—but that they want to take different paths to achieve those goals. 

For example, Azar did not take issue with GOP plans to repeal the individual mandate through its tax plan. He said the mandate forces penalties on people who cannot afford pricey individual marketplace plans. 

He also refused to say he would oppose the Trump administration's changes to the contraceptive mandate, saying it's crucial for agencies like HHS to strike a balance between access and the conscience objections of employers. 

However, he did express strong support for the ACA's goals of payment reform and the transition to value-based care. Sen. Sheldon Whitehouse, D-R.I., described two successful accountable care organizations in his state, and Azar said he would gladly work alongside such groups if he were confirmed to lead HHS. 

Improving care coordination and integration is central to his goals at HHS, Azar said. "There is so much opportunity for bipartisanship here," he said.