Government healthcare regulatory agencies and bureaus
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Government Healthcare Agencies
Business Trends...
  • Commercial, Medicaid, Medicare, 340B and DHA/TRICARE payer sectors plus pharmaceutical and medical device manufacturers and healthcare service providers are impacted by COVID-19 regulatory measures
  • Pressure on the FDA, CDC, CMS, NIH and other federal healthcare agencies continues in 2021 as the pandemic evolves
  • Scroll down to access a reference of direct links to leading government healthcare agencies and regulatory units

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Government Healthcare Agency Market Sector Overview

The six major government healthcare programs—MedicareMedicaid, the State Children’s Health Insurance Program (SCHIP), the Department of Defense ( DOD ) DHA / TRICARE and TRICARE for Life programs (DOD TRICARE), the Veterans Health Administration (VHA) program and Indian Health Services (IHS) program—provide healthcare support to roughly one-third of Americans.  Their combined budgets total roughly $500 billion (pre-pandemic) and even their longest-standing policies and processes have been changed forever by COVID-19.

Cost and care hurdles coupled with ceaseless healthcare policy and regulatory changes will keep industry and government stakeholders on the move in 2021. These developments have become more granular and far-reaching with more patient, clinician, reimbursement and technology elements undergoing changes that will be permanent. 

Patient Care Delivery Clinical And Business Model Changes Impact Reimbursement 

Examples of changes in the marketplace which have spurred Federal and State governments to take further action as a result of healthcare reform measures include:

  • Health plans withdrawing from state health exchanges
  • New physician practice, health system and managed care organization business models
  • Continual revisions to Federal and State reimbursement arrangements in multiple sectors
  • New dialysis policy decisions by Centers for Medicare & Medicaid Services (CMS) and final rule on reimbursement  for End-Stage Renal Disease (ESRD) and acute kidney injury (AKI) dialysis ESRD Quality Incentive Program (QIP).

Technology Is Transforming Healthcare And Regulatory Oversight Is Necessary

Technology has created enormous innovation and change. Examples include telemedicine/telehealth, IoT, mobile, privacy / security of patient information, growing varieties of social media venues and their use by consumers / patients, clinicians, insurers, healthcare marketers and other stakeholders. Administration, privacy, security, standardization, technical quality assurance and regulatory authority are some of the key considerations Federal and State lawmakers are dealing daily with as technology makes rapid inroads across the continuum of care. 

In response to the escalating opportunities for technology to improve healthcare in the United States, the Federal government launched the U.S. Food and Drug Administration's Digital Health Center of Excellence during the final months of 2020.

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