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ADEA Advocacy and Government Relations — March 2014

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The ADEA Advocacy and Government Relations portfolio recently attended the Academy Health National Health Policy Conference February 3–4 in Washington, D.C. The conference is designed to bring together health policy leaders from around the country to discuss critical health care issues.

From the White House Office of Health Reform, Jeanne Lambrew said that from 2000 to 2009, the United States experienced the lowest sustained growth of health care expenditures since the United States began keeping records.

Ms. Lambrew said that as many as 129 million Americans have pre-existing conditions, and the Affordable Care Act (ACA) is designed to ensure that those Americans can obtain insurance. Additionally, thanks to the ACA, 3.1 million young adults (up to the age of 26) were able to be on their parents’ health insurance plans. The White House is working on making the healthcare.gov website more user friendly, she said, and continues to market to young adults via social media in hopes more sign up.

As millions of Americans enter into the health care system in the coming years, primary care providers must identify ways to expand access, improve quality and control costs. Innovative models to expand primary care, including new health workforce strategies, have the potential to improve patient experiences and outcomes. In addressing coming shifts in the health care workforce, Pauline Lapin from the Centers for Medicare and Medicaid Services (CMS) spoke about measuring the effectiveness of the Comprehensive Primary Care (CPC) initiative.

The CPC initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. CMS partnered with multiple insurers to examine the impact of the initiative on health, quality and costs. Specifically, CMS used nine milestones to assess the initiative, ranging from budgetary goals to examples of care coordination and shared decision-making. On January 1, 2014, approximately 500 practices had submitted relevant information to CMS. According to Ms. Lapin, the findings demonstrate that smaller practices were likely to follow more traditional staffing structures, whereas, the Patient Centered Medical Homes (PCMHs), which followed the CPC initiative, were likely to have more non-traditional staff, such as care coordinators, resulting in increased access to care.

At a Congressional Plenary session, Rep. Robert Wittman (R-VA) said that patients need to be empowered, which he explained, meant that there ought to be more transparency in billing so patients know the true cost of services and that patients and providers need to be in charge. In his district, smaller district hospitals in rural areas have been bought out by larger regional hospitals. He said that community health centers and free health clinics in his district have served as excellent sources for low-income families to access health care.

Following the plenary, a panel of Capitol Hill staffers discussed Congress’s future priorities. They said the Senate Committee on Health, Education, Labor, and Pensions (HELP) will continue to monitor implementation of the ACA. Further, delivery system and payment reform will also be under discussion. Additionally, panelists noted that the House Committee on Ways and Means will continue its focus on the sustainable growth rate payment system.

Finally, panelists said that members of Congress will allow the Ryan White Program to continue as it is currently structured and appropriate funds for the program despite its need for reauthorization. Members of Congress plan to see how the program coincides with the ACA before determining its future and pursuing a formal reauthorization. The Ryan White Program has been reauthorized by Congress four times since first created (1996, 2000, 2006 and 2009), and does not include a “sunset clause” that would foreclose the Congress’s ability to continue funding the program despite the missed deadline for reauthorization. According to the Capitol Hill staffers, the U.S. Department of Health and Human Services is reviewing duplicate programs, and some believe the Ryan White Program may be shifted to wraparound services, rather than primary care. The audience was strongly encouraged to actively communicate with members of Congress about the importance of the Ryan White Program.

For a summary on recent federal legislative and regulatory news about oral health, dental education, and dental research, read our ADEA Washington Update.

Keep up with recent state legislative and regulatory news about oral health, dental education, and dental research in your state with the ADEA State Update.