Where Healthcare Policy Is Headed | Chief Counselor at HHS, Chris Klomp
The Heart of Healthcare | A Digital Health Podcast
Prior Authorization as a Trust Wedge
Chris calls prior authorization the top patient/provider pain point and outlines industry commitments to fix it.
Chris Klomp, Director of Medicare and Deputy Administrator of CMS, and Senior Advisor to HHS Secretary RFK Jr., has big ambitions to reshape how healthcare works in the United States.
This week, Steve sits down with Klomp to discuss how his experience as a digital health entrepreneur is guiding his current role overseeing a roughly $2 trillion department. Klomp shares the government's strategy for restoring trust between providers and payers, driving down costs, and addressing a system where approximately 90% of healthcare dollars are still spent in a fee-for-service arrangement.
We cover:
- Why 90% of US healthcare remains fee-for-service after two decades of reform.
- The intentional design of the new Access model to be deflationary and fuel entrepreneurship among insurgents.
- The commitment from the payer industry to make prior authorization invisible to patients and providers by 2027.
- CMS's aggressive stance on data interoperability and funding enforcement against data blocking.
- How the Most Favored Nation policy is re-wiring global prescription drug supply to lower prices without compromising innovation.
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About our guest:
Chris Klomp is the Director of Medicare and Deputy Administrator of CMS, and Senior Advisor to HHS Secretary Robert F. Kennedy Jr. With extensive experience in healthcare payment reform and data sharing, he built and led Collective Medical, the largest U.S. real-time care collaboration data network, acquired by PointClickCare in 2020. There, he partnered with health systems, plans, providers, post-acutes, and state governments to advance value-based care through enhanced data access and insights.
Chris has driven healthcare reform at state and federal levels, focusing on value-based care and interoperable health technology. Through Endurance Companies, a San Francisco-based multi-family office he co-founded with Stanford classmates, he has co-founded, invested in, advised, and served on the board of many innovative healthcare organizations, including Nomi Health, Maven Clinic, InnovaCare Health, and Health Joy. He also served as a Utah Senate-confirmed commissioner of the Utah Digital Health Services Commission, where he focused on leveraging technology for cost-effective, healthier outcomes. Previously, he was Vice President in Bain Capital’s North American Private Equity group and worked at Bain & Company. Recognized as Utah Business’ CEO of the Year and EY’s Mountain Region Entrepreneur of the Year, Chris holds a B.A. with honors in Economics and English from Brigham Young University and an MBA from Stanford.
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🙏 Thank you to our show sponsor, Quickstudy PR, story brokers for leading healthcare executives. Learn more about quickstudypr.com.
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