NCHC Forums bring together thought leaders, policymakers and stakeholders for timely public discussions about the future of America’s health system. The views expressed by the speakers are their own and do not reflect the positions of the National Coalition on Health Care or NCHC Action Fund.
All Upcoming 2012 2013 2014 2015 2016
WITHHOLDS, ACCOUNTABLE CARE, AND AFFORDABLE MEDICARE POLICY
10:00 AM – 11:30 AMLongworth House Office Building, Room 1300
America’s health system faces a crisis of value. In an effort to stimulate dialogue and offer opportunities to learn about emerging and resurgent ideas for addressing this crisis, the National Coalition on Health Care is launching its NCHC Forums, an ongoing program of monthly educational briefings that will showcase a rich variety of speakers and topics.
Our inaugural forum will feature Dr. Elliott Fisher of the Dartmouth Institute of Health Policy and Clinical Practice. Dr. Fisher and his colleagues at the Dartmouth Institute have been important intellectual leaders in the national effort to understand the complex challenge of health spending, producing influential analyses of variation in health care costs and advancing innovative solutions like Accountable Care Organizations and shared decision-making.
In their January 2012 JAMA article, “Withholds to Slow Medicare Spending: A Better Deal than Cuts,” Drs. Fisher, Skinner and Weinstein offer a new approach that seeks to accelerate delivery reform, achieve scoreable savings and avoid across-the-board cuts in provider reimbursement. As policymakers struggle in the coming months to find sustainable solutions to Medicare’s provider payment and overall health spending challenges, Dartmouth’s ideas could move to the forefront of the health policy agenda.
INNOVATIVE PRIVATE SECTOR STRATEGIES TO CURB HEALTH COSTS
10:00 AM – 11:30 AMCapitol Visitors Center, Room SVC 212-10
Tom Leyden, MBA, Director, Value Partnerships, Blue Cross Blue Shield of Michigan
Larry Boress, President and CEO, Midwest Business Group on Health
America’s health system faces high and rising costs and persistent issues related to quality of care. In an effort to stimulate dialogue around solutions to these challenges, the National Coalition on Health Care has launched its NCHC Forums series to showcase the perspectives of health care innovators and thought leaders. This forum features two private sector leaders who have demonstrated that it is possible to drive down health care costs while improving outcomes.
Mr. Leyden will discuss the powerful partnerships that Blue Cross Blue Shield of Michigan has forged with hospitals, physicians’ groups, and individual providers throughout his state. Value Partnerships’ nationally recognized efforts to reduce medical errors, promote the highest-quality evidence-supported care, and implement the patient-centered medical home model have yielded real cost savings by focusing on improving quality and outcomes.
Mr. Boress will discuss employer efforts to confront the rising cost of diabetes, particularly MBGH’s innovative Take Control of Your Health program, which provides employees diagnosed with diabetes with personalized health coaching from specially trained clinical pharmacists. This program, furnished to regional employers in partnership with the Illinois Pharmacists Association, has helped employees better manage their own health and improve their employers’ bottom line.
As policymakers work to keep federal health care programs on a sustainable footing, private sector initiatives like these can help point the way toward a health system we can all afford.
NEW PATHS TO HEALTH CARE VALUE: PERSPECTIVES ON MEDICARE POLICY FROM COST AND QUALITY LEADERS
Greg Poulsen, Senior Vice President, Intermountain Healthcare
Chris Wing, President and CEO, Scan Health Plan
CURBING COSTS WHILE EXPANDING COVERAGE: STRATEGIES FROM MASSACHUSETTS AND CALIFORNIA FOR A POST SCOTUS WORLD
David Cutler, PhD, Otto Eckstein Professor of Applied Economics at Harvard University
William Kramer, Executive Director, National Health Group, Pacific Business Group on Health
SUGARY DRINKS, A PUBLIC HEALTH CHALLENGE: USING TAX POLICY TO PROMOTE WELLNESS AND PREVENTION
10:00 AM – 11:30 AMRussell Senate Office Building, Room 485
Rachel Johnson, PhD, Professor of Nutrition and the University of Vermont Chair, Nutrition Committee, American Heart Association
Michael F. Jacobson, PhD, Executive Director, Center for Science in the Public Interest
Robert Greenstein, Founder and President, Center on Budget and Policy Priorities
Consumption of added sugar is one of the most significant public health hazards of our time. Research shows that excess intake of added sugar leads to considerable health, economic, and social costs. Almost half of the added sugar in the American diet is found in sugary beverages like soda, sports drinks, energy drinks (36%) and fruit drinks (11%). Reducing the consumption of sugary beverages, which typically do not satiate hunger or provide nutritional benefits, may lead to substantial gains in the health of the nation.
In an effort to achieve that goal, one policy option now under consideration is changing the relative price of sugary beverages through taxation. This forum will review the health consequences of sugary beverage consumption, explore tax policy as a mechanism for health behavior change and discuss the economic and public health benefits that could stem from a tax on sugary beverages.
SEPARATING POLITICS FROM HEALTH CARE CHOICES: KEY “PURPLE” MESSAGES FOR ALL CONSUMERS
2:30 PM – 5:00 PM The Pew Charitable Trusts Conference Center, Washington, DC
Leah Binder, Chief Executive Officer, The Leapfrog Group
Ann Boynton, Deputy Executive Officer, California Public Employees’ Retirement System
Wendy Lynch, Co-Director, Altarum Institute Center for Consumer Choice in Health Care
Jon Skinner, Professor, Dartmouth Institute of Health Policy and Clinical Practice
The National Coalition on Health Care and the Altarum Institute are cosponsoring a roundtable discussion on health care consumerism. The event will focus on the following three “purple,” or politically independent, themes that apply to all health care consumers:
(1) For every condition, there is always more than one treatment (or nontreatment) option.
(2) For any treatment, there can be significant variation in the safety and quality of its delivery.
(3) Within the same level of quality and safety, there can be vast differences in price.
Presenters will address the universal relevance of these three themes to improve the value and affordability of health care. By setting aside preconceived biases about consumer strategies and focusing on the value of transparency and choice, session participants will seek an acceptable platform on which to build support for consumer involvement.
AFTER THE SGR: BUILDING A TRANSFORMED PAYMENT AND DELIVERY SYSTEM
10:00 AM – 11:30 AMWest Health Policy Center, 1909 K St NW, Suite 730, Washington, DC 20006
Blair Childs, Senior Vice President, Premier
R. Shawn Martin, Vice President for Policy and Practice Advancement, American Academy of Family Physicians
Kim Allan Williams, MD, Vice President, Board of Directors, American College of Cardiology
Could 2013 be the year? A consensus is emerging in Washington that this is the year to put the annual threat of SGR-driven Medicare provider cuts behind us. More importantly, the medical community, key Committees in Congress, the Obama administration and the broader stakeholder community are uniting around the idea that repeal of the Sustainable Growth Rate (SGR) formula must be paired with policy changes that moves from today’s volume-based reimbursement toward an approach that supports better care at lower cost.
At this NCHC Forum, you’ll hear from three leaders at the center of this exciting debate. They will share the perspectives of family practitioners, an innovative medical specialty organization and the nation’s leading hospitals on this year’s opportunities and the future of health care delivery and payment policy.
IMPROVING PATIENT QUALITY OF LIFE: THE ROLE OF PALLIATIVE CARE
2:30 PM – 4:00 PM ESTRayburn House Office Building, Room 2168
Host: United States Representative Eliot Engel
Amy Berman, RN, Senior Program Officer, The John A. Hartford Foundation; living with stage IV breast cancer
Diane Meier, MD, Director, Center to Advance Palliative Care, Mt. Sinai Medical Center
Sean Morrison, MD, Director, Lilian and Benjamin Hertzberg Palliative Care Institute, and Director, National Palliative Care Research Center, Mt. Sinai Medical Center
Palliative care provides an extra layer of support for people of any age and at any stage of a serious disease such as cancer, and can be provided alongside curative treatment. Palliative care relies on interdisciplinary teams of providers to coordinate and deliver care- centered on the patients’ needs and preferences. It focuses on treating the disease while also ensuring the best possible quality of life for the patient. Research demonstrates that palliative care can improve outcomes and improve patient satisfaction, but too often patients are not offered the choice to pursue palliative care. This forum will address the barriers to broader access to palliative care and explore what health care stakeholders and policymakers can do to address them.
EPISODIC BUNDLED PAYMENT: A CRITICAL NEXT STEP IN HEALTH CARE PAYMENT REFORM
10:00 AM–11:30 AM ESTRayburn House Office Building, Room 2456
Blair Childs, Senior Vice President, Premier Healthcare Alliance: Premier: Improving Quality While Safely Reducing Costs
Eric Berger, President and CEO, Partnership for Quality Home Healthcare: Improving Clinical Outcomes and Program Efficiency in a Pro-Patient Manner
Topher Spiro, Vice President of Health Policy, Center for American Progress: Medicare’s Acute Care Episode Program
Health care experts have concluded that every year billions of dollars are wasted and enormous patient harm can occur due to a lack of coordination among providers during and after a hospitalization. Today, Medicare is testing approaches that replace traditional fee-for-service payments with bundled payments that incentivize hospitals and post-acute providers to work together. In fact, we already know from previous Medicare demonstrations that episodic bundling does improve quality and drive down costs.
Is it time to move forward more aggressively with bundled payment in Medicare? The speakers at this event believe it is, and each has proposed dramatic expansions of this innovative approach to payment reform.
A PRESCRIPTION FOR SAVINGS: MEDICATION MANAGEMENT AND IMPROVED ADHERENCE
2:30 PM – 4:00 PMRussell Senate Office Building, Room 485
Anita Allemand, Vice President for Product Innovation and Management, CVS Caremark: A Prescription for Savings: Medication Management and Improved Adherence
John O’Brien, Vice President, Public Policy, CareFirst BlueCross BlueShield: Focus on Medication Management
John McGlew, Assistant Director, Government Affairs, American College of Clinical Pharmacy: Medication Management and Improved Adherence
What do five of the top ten most expensive medical conditions have in common? Heart disease and related conditions, depression and other mental disorders, asthma, COPD, diabetes and high blood pressure can all be managed with the right medical care and the help of the right medication. But our health system too often fails to get patients the right medicine at the right time. When that happens, patients suffer and health care costs skyrocket. Our speakers—representing a pharmacy innovation company, a leading regional health plan, and a pharmacy society—have tackled this challenge head-on. And the results have been better patient care at lower cost.
IMPROVING MEDICARE POST-ACUTE CARE TRANSFORMATION (IMPACT) THROUGH STANDARDIZED ASSESSMENT DATA
12:00 PM – 1:30 PMDirksen Senate Office Building, Room G-11
David Gifford, Senior Vice President of Quality and Regulatory Affairs, American Health Care Association
Judith Tobin, Managing Director, Engelberg Center for Health Reform, Brookings Institution
Join the National Coalition on Health Care and Long Term Quality Alliance for a briefing on the Improving Medicare’s Post-Acute Care Transformation (IMPACT) Act by Dr. David Gifford, MD, MPH, and Judith Tobin. Dr. Gifford is the Senior Vice President of Quality and Regulatory Affairs at the American Health Care Association and Ms. Tobin is the Managing Director of the Engelberg Center for Health Care Reform at Brookings Institution.
The lack of comparable data across Medicare’s post-acute care settings complicates coordination of care and measurement of quality and outcomes. The IMPACT Act would lay the foundation for comparing quality across settings, improving discharge planning, and modernizing post-acute care payments by requiring post-acute providers to report standardized assessment data and quality measures. Dr. Gifford and Ms. Tobin will discuss ongoing efforts to measure and improve quality and the impact this simple legislation could have on future costs and quality of Medicare post-acute care.
HEALTH CARE QUALITY AND EFFICIENCY: THE ROLE OF CONSUMER ENGAGEMENT AND IMPROVED DIAGNOSTIC AND THERAPEUTIC ACCURACY
10:00 AM – 11:30 AMDirksen Senate Office Building, Room G-11
Lewis Levy, Vice President of Corporate Medical Quality, Best Doctors
Ken Stuart, Administrative Manager, San Diego Electrical Health and Welfare and Pensions Trusts
George McGregor, President & CEO, McGregor & Associates Inc.
With health care reform, there is an increased focus on the important role of consumer engagement in improving population health outcomes. Purchasers are focused on providing consumers with resources and tools that enhance clinical quality through the consideration of medical appropriateness to mitigate variations. Trends include the addition of services like Expert Remote Second Opinion and Treatment Decision Support. Behavioral economics approaches such as financial incentives tied to health coverage have been introduced to engage individuals in these programs. This forum will highlight some of the most promising approaches in this increasingly important area.
HEALTH POLICY AFTER THE SGR: WHAT’S POSSIBLE IN VALUE-BASED PAYMENT AND BENEFITS?
9:00 AM – 10:30 AM Capitol Visitors Center, SVC-203
Shaun Frost, MD, Associate Medical Director for Care Delivery System, HealthPartners Health Plan: Value Based Insurance Design: Key Concepts and their Application at HealthPartners Health Insurance Plan
William Kramer, MBA, Executive Director for National Health Policy, Pacific Business Group on Health: Health Policy after the SGR: Moving Towards Value-Based Payments and Benefits
Mara McDermott, JD, MPH, Director of Federal Affairs, CAPG: Post-SGR Opportunities for Value-Based Healthcare Delivery
“If there’s no SGR, what will we do all day?” This facetious quip has long brought smiles to the faces of advocates and Hill staff. But if Congress does manage to end the annual “doc fix” ritual, the work of reforming health care reimbursement and benefits is only just beginning. Recently announced goals, like driving 50% of traditional Medicare reimbursement through alternative payment models and basing 75% of private-sector payment arrangements on value, seem miles off.
To help map out a route toward achieving these goals, NCHC has brought together panelists with two specific qualifications. First, the private-sector physician groups, health plans and employers have each achieved real-world savings and care improvement, through new models of provider reimbursement and benefit design. Second, they each have ideas about what policymakers can do to bring those successes to scale—after the SGR.
BENDING THE HEALTH CARE COST CURVE: THE ROLE OF INVESTMENTS IN PREVENTION
2:30 PM – 4:00 PMRayburn House Office Building, Room 2226
David Dobbins, Chief Operating Officer, Legacy: Tobacco and Smoking: Progress and Challenge in Disease Prevention
Rich Hamburg, Deputy Director, Trust for America’s Health: Bending the Health Care Cost Curve: The Role of Investments in Prevention
Chris Hansen, President, American Cancer Society Cancer Action Network: Bending the Health Care Cost Curve: The Role of Investments in Prevention
Experts attribute 75% to 90% of America’s $2.7 trillion health care spending to largely preventable chronic conditions like diabetes, heart disease, asthma, cancer, and arthritis. Yet our policy debates and budget choices, centered on our expensive“sick” care system, shortchange the investments needed curb the growing cost prevalence of chronic disease. As leaders with organizations nationally recognized in the areas of tobacco use, community prevention, and cancer, respectively, our speakers will outline successful strategies in the battle against chronic disease and explore how to better target federal spending to expand those successes.
MEDICARE CLIFF: WHO’S IMPACTED BY PROJECTED 52% JUMP IN MEDICARE PREMIUMS? WILL WASHINGTON DO SOMETHING ABOUT IT?
9:00 AM – 10:30 AMRayburn House Office Building, Room B-318
Jane Cheshire Gilbert, Director of Retiree Health Care, Kentucky Teacher’s Retirement System: Kentucky Teachers’ Retirement System
Tricia Neuman, Senior Vice President and Director of Program on Medicare Policy and Project on Medicare’s Future, Kaiser Family Foundation: Medicare Part B Premium and Deductible: What’s in Store for 2016?
Andrew Scholnick, Senior Legislative Representative, AARP: Impact of Medicare Part B Increases on Beneficiaries
Shannon McMahon, Deputy Secretary for Health Care Financing, Maryland Department of Health and Mental Hygiene: View from Maryland: Impact of Medicare Part B Premium Increases
Can Congress or the administration stop a 52% jump in medicare Part B premiums and deductibles? If initial projects from the Medicare Trustees’ Report bear out, millions of Medicare beneficiaries could be impacted by Part B premium and deductible increases of up to 52%. Our distinguished panel of experts and advocates will identify who could be affected, explore the roots of this problem current statute and health care spending and explain the impact of this potential cost-shift on family finances and state budgets.
TRANSFORMING PRIMARY CARE: SCALING UP SUCCESSFUL MEDICAL HOME PROGRAMS
3:00 PM – 4:30 PMDirksen Senate Office Building, Room G-11
Margaret E. O’Kane, President, National Committee on Quality Assurance: Advancing Patient-Centered Medical Homes (PCMH)
Shawn Martin, Senior Vice President, Advocacy, Practice Advancement, and Policy, American Academy of Family Physicians: Scaling Up Successful Medical Home Programs
K. Eric De Jonge, MD, Director of Geriatrics, MedStar Washington Hospital Center: Independence at Home—the Case for National Access
Are advanced medical home models the key to health care transformation? Patient-centered medical homes, which represent a team based approach to primary care, have long promised to improve care and value. And from private initiatives and federal demonstrations like the Independence at Home Practice Demonstration and Comprehensive Primary Care initiative, evidence is building that this promise can be realized. At this forum, our speakers will outline how federal policy can build on these successes, bringing superior primary care within reach for millions while holding down health care costs.
IMPROVING CHRONIC CARE IN MEDICARE ADVANTAGE AND BEYOND
9:00 AM – 10:30 AM Capitol Visitors Center, SVC 209/208
Margaret A. Murray, Chief Executive Officer, Association for Community Affiliated Plans: Improving Chronic Care in Medicare Advantage and Beyond
Ann Hwang, MD, Director, Center for Consumer Engagement in Health Innovation, Community Catalyst: Medicare Advantage and Chronic Care
Peter Begans, Senior Vice President, SCAN Health Plan: What can Congress do to Improve Chronic Care?
Just 5% of beneficiaries, often those living with multiple chronic conditions and facing significant socio-economic challenges or functional limitations, can generate nearly half of the health care spending. An increasing number of Medicare Advantage plans are embracing the challenge of caring for the chronically ill and developing innovative strategies to improve both their care and their quality of life.
At this forum, representatives from health plans and consumer advocacy communities will identify the policy barriers to superior care for the chronically ill and explore how to surmount them. Topics addressed will range from risk adjustment and the STARS quality system to Special Needs Plans and long-term services and supports.
THE ESCALATING COSTS OF HEALTH COVERAGE: CAUSES, IMPACTS, AND OPTIONS
10:30 AM – 12:00 PMRussell Senate Office Building, Room 485
Paul Ginsburg, Director, Brookings Institution Center on Health Policy, and Chair in Health Policy Studies, Schaeffer Center for Health Policy and Economics, University of Southern California: Fostering Competition in Consolidated Markets
Sara Collins, Vice President, Health Care Coverage and Access, Commonwealth Fund: The Problem of Underinsurance
Damon A. Silvers, Director of Policy and Special Counsel, AFL-CIO: The Escalating Costs of Health Coverage
Scott A. Weltz, Principal and Consulting Actuary, Milliman, and Coauthor of the 2015 Milliman Medical Index report: 2015 Milliman Medical Index
The costs of health coverage are again escalating much more rapidly than general inflation—which puts increasing pressure on wages and jobs, access to needed health care, employer and family budgets, productivity, and the global competitiveness of American firms. In this National Coalition on Health Care Forum, a distinguished panel will analyze and explain the causes and effects of these accelerating costs—and strategies for slowing the rates of increase and reducing their harmful impacts. Please join us for this important and timely briefing and discussion.