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Conway: Medicare's Venture Capitalist

By Kerry Young, CQ Staff

July 6, 2015 -- Patrick Conway is leading what's been described as a $10 billion venture capital firm within the federal government's Centers for Medicare and Medicaid Services (CMS).

But instead of funding fledgling biotech firms or surgeons tinkering with new medical devices as private venture capitalists do, the Center for Medicare and Medicaid Innovation (CMMI), headed by Conway since 2013, provides money for hospitals and medical practices trying to improve care while reining in costs.

"That capital infusion allows them the time and resources to redesign their practices," Conway tells CQ, adding that one participant in a CMMI program told him he would have had to mortgage his home several times over to get access to money for this purpose on his own. "These small physician practices are essentially small businesses," he says.

It's still too early to judge how well CMMI's projects will do. The results from its $1 billion Health Care Innovation awards program have been mixed so far. The biggest success to date for CMMI appears to be a program meant to better coordinate treatment of patients, known as the Pioneer Accountable Care Organization model. Medicare's expenses appear to have been shaved by roughly $385 million through work done by hospitals and medical groups participating in the program.

Mark McClellan, who led CMS in the George W. Bush administration, credits this progress in part to the multiple roles that Conway plays within the agency. A talented data cruncher, Conway also oversees the Center for Clinical Standards and Quality within CMS and is the agency's chief medical officer. In these posts, Conway works with officials throughout the agency to speed feedback to doctors and others participating in CMMI test programs.

"Things like that are not strictly part of CMMI since they go to the more fundamental design of Medicare's data systems and how Medicare interacts with providers, but it is definitely part of his portfolio," says McClellan, who now leads the Health Care Innovation and Value Initiative at the Brookings Institution. "It is making a difference."

The innovation center's future, however, is less certain. The 2010 health care overhaul, which created CMMI, set a fiscal 2019 deadline to spend the $10 billion initially provided by Congress. The law calls for continued funding after that, but GOP opposition could be an obstacle. An even more immediate threat is a draft spending bill released last month from House GOP appropriators that would rescind the center's remaining $6.8 billion.

A pediatrician who graduated from Baylor College of Medicine in 2002, Conway brings added credibility by continuing to practice medicine. The married father of three small children finds time for weekend shifts every six weeks or so at a children's hospital, work that he describes as "recharging" for him.

Conway frequently recalls how he witnessed, early in his training, the death of a baby due to an infection from a tube placed in the chest. At the time, many doctors considered such hospital-acquired infections unavoidable. Since then, there's been a campaign to head them off with more thorough cleaning of skin and equipment, with some of this work done by CMMI projects.

Conway says he sees a rapidly accelerating "trajectory of improvement" currently taking place in American health care. "It's really moving in the right direction."

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