Patrick H. Conway, MD, MSc, has had an interesting journey. He is a Texas resident who became a pediatrician after his residency at Harvard Medical School at Boston Children’s Hospital and is still practicing clinically. He was a White House fellow and then worked his way up through the federal government.

He is currently the deputy administrator for innovation and quality at the Centers for Medicare & Medicaid Services (CMS) and director of its Center for Medicare & Medicaid Innovation (CMMI). He also sees patients as a pediatric hospital medicine attending, and his clinical work helps shape his policy work at CMS.

In his various roles, he keeps four important job criteria in mind:

1. Family
2. Impact (the Triple Aim)
3. Learning
4. People, which originally meant mentorship but has grown to encompass the people and culture of the organization

Dr. Ricardo Martinez
PHOTO: Ricardo Martinez

Dr. Conway recently sat down with ACEP Now editorial board member Ricardo Martinez, MD, FACEP, chief medical officer for Adeptus Health in Lewisville, Texas, and assistant professor of emergency medicine at Emory University in Atlanta, to discuss his role at CMS and what the future may hold for emergency medicine.

RM: Patrick, you’ve had a very interesting journey, both in health care and in government. What drives you?

PC: What drives me, and has for probably the last 20 years, is trying to have the largest positive impact on the US health system possible. I know that sounds like a bold goal, and I certainly struggle to achieve it at times, but I’ve been really focused on better care, better health, and lower cost throughout my career. As you’ve mentioned, I’ve been in government through a couple tours of duty and probably would not have predicted that when I was in my first job at McKinsey Consulting before I went to medical school. The core of what I’m passionate about is how to deliver better care to people and to populations of patients.

RM: You’re at the Department of Health and Human Services during a very interesting time. In truth, government work gives you low pay and long hours but an opportunity to make a great difference. One of the roles you have is director of CMMI. Can you tell us a little bit about that organization and some of the innovations that you’ve seen?

PC: I came in originally to CMS as the chief medical officer and ran our quality center. Don Berwick was the administrator at the time and then, over four years ago, he was asked to run CMMI, the innovation center. The whole point of the innovation center is to test new payment and service delivery models like accountable care organizations, bundled payments, primary care medical homes, and state-based innovation. If those models improve quality and lower cost for patients, then we’re able to scale those models up nationally. The innovation center is really an exciting sort of innovation engine. It’s funded at $10 billion over every 10 years, but the scale of change can be enormous. Just to give you a few numbers, we put out a report to Congress at the end of last year, and we now are working with over 200,000 providers—and even more physicians because a provider can be a hospital, a physician group, or a post-acute facility. Those providers are serving about 27 million patients directly and over 200 million Americans indirectly.