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How Will the Next Administration Impact How You Deliver Care

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... both the Democrat and Republican health policy platforms will impact healthcare. ... 2008 Healthcare Policy Landscape. Health Information Technology ... – PowerPoint PPT presentation

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Title: How Will the Next Administration Impact How You Deliver Care


1
How Will the Next Administration Impact How You
Deliver Care?
2
Todays Presenters
Jon Glaudemans Managing Director, Health
Strategies Avalere Health LLC
Ann Richardson Berkey Senior Vice President,
Corporate Public Affairs McKesson Corporation
3
Learning Objectives
  • Identify how items on both the Democrat and
    Republican health policy platforms will impact
    healthcare.
  • Communicate why clinical leaders are needed to
    help form healthcare policy.
  • Outline ways nurse and physician leaders can get
    involved to influence healthcare policy.

4
2008 Healthcare Policy Landscape
PDMA
Pedigree
Vaccines
HSAs
Health Information Technology
Importation
Medicare Rx Pricing
Consumer Health
AWP Reform
Health Data
Biologics
Packaging
State Licensure
e-Prescribing
Rx Pricing
Healthcare Reform
P4P
Generics
Telehealth
Coverage of Uninsured
Patient Safety
Medical Home
Congressional Oversight
Personal Health Record
Quality Outcomes
FDA Oversight
Senior Drug Benefit
AMP/ASP
HIPAA / Patient Privacy
Avian Flu
Electronic Health Records
Interoperability Standards
Product Safety
Medicaid Reform
Genomics
Care Coordination
Payment Reform
5
Drivers This Election Year

Economy
Ranking of Healthcare
Democrats 3 Independents 4 Republicans 5
Iraq
Healthcare
Gas Prices
Within healthcare, the following are ranked as
the most important issues COST 53
making healthcare and insurance more affordable
ACCESS 18 expanding insurance coverage
for the uninsured QUALITY 10 improving
quality of care and reducing medical errors
Kaiser Family Foundation Health Tracking Poll,
August 2008
6
Change is Certain in All Governance Scenarios
Composition of the Senate will have the most
impact on health and entitlement reform
legislation in 2009
7
Déjà Vu All Over Again?
Sources Kaiser Family Foundation, the
Organization for Economic Cooperation and
Development, the U.S. Census Bureau, the Bureau
of Labor Statistics, the Congressional Budget
Office, and a poll conducted by CBS News and the
New York Times. http//content.nejm.org/content/vo
l357/issue17/images/large/01t1.jpeg
8
Health Reform Critical Issues
  • Access
  • Coverage
  • Barriers
  • Geographic
  • Financial
  • Cultural
  • Provider availability
  • Access
  • Coverage
  • Barriers
  • Geographic
  • Financial
  • Cultural
  • Provider availability
  • Quality/Safety
  • HIT infrastructure
  • Accountability
  • Report cards
  • Product safety
  • Import safety
  • Quality/Safety
  • HIT infrastructure
  • Accountability
  • Report cards
  • Product safety
  • Import safety
  • Cost
  • Aging population
  • Chronic disease
  • Innovation
  • Geographic variation
  • Cost
  • Aging population
  • Chronic disease
  • Innovation
  • Geographic variation

9
Care/Staffing Models Strategies
1
Challenges
Strategies
Resource Demands
Quality/Safety Improvement Programs
Additional Physicians and Nurses Workflows
Physician and Nurse Shortages
Care Coordination
IT Support Tools
Autonomy
Reimbursement Challenges
Medical Home
Incentives
Provider Education Issues
Disease Management
Provider Training
10
Delivery System (Re)Organization
2
  • Two Key Trends
  • Clinical care provided in more settings
  • Shift of diagnostics, treatments, and surgeries
    to the ambulatory setting
  • Number of specialty hospitals increasing
    significantly (e.g., cardiac and orthopedic)
  • Community home-based care used to provide
    comprehensive care
  • Horizontal/Vertical integration underway
  • Hospital mergers decrease the number of hospitals
  • Hospitals incorporate ambulatory care centers

More settings of care and more specialization
Require better coordination, information
11
Aligning Incentives/Pay-for-Performance
3
Pay-for-Performance
  • Quality measurement
  • End-to-end metrics
  • Public reporting
  • Report cards
  • Provider tiering
  • Innovative reimbursement models
  • Gainsharing
  • Never events
  • Episodes of care


Value-based Purchasing
12
Health Disparity/Equity
4
13
Critical Policy Issues Access Improvement
Source KFF 2008 Presidential Candidate Health
Care Proposals Side-by-Side Summary
http//www.health08.org/sidebyside_results.cfm?c5
c16
14
Critical Policy Issues Quality Improvement and
Cost Containment
Source KFF 2008 Presidential Candidate Health
Care Proposals Side-by-Side Summary
http//www.health08.org/sidebyside_results.cfm?c5
c16
15
Critical Policy Issues Workforce Support
Source KFF 2008 Presidential Candidate Health
Care Proposals Side-by-Side Summary
http//www.health08.org/sidebyside_results.cfm?c5
c16 ANA Policy and 2008 Presidential
Candidates Senator John McCain (R-AZ) and
Senator Barack Obama (D-IL) http//www.nursingworl
d.org/MainMenuCategories/HealthcareandPolicyIssues
/HSR/ANAPolicyand2008PresidentialCandidates.aspx
16
What to Watch For
Will the Perfect Become the Enemy of the Good?
CAG Coverage and Analysis Group
17
Some Key Clinician Issues
  • Reimbursement Reform
  • Expanding Coverage for Uninsured
  • Medicare Payment Reform
  • E-prescribing
  • Medical Liability Reform
  • Physician-driven Quality Standards
  • Promotion of Healthier Lifestyles
  • Staffing
  • Clinician Shortages
  • Patient Safety
  • Education
  • Nursing Documentation
  • Health IT Systems

18
Post-Election Policy Priorities
Regulation/Executive Order
  • Non-payment for errors
  • Standardized reporting
  • ICD-10/HIPAA 5010
  • AMP Implementation
  • ASP Reduction
  • Care Coordination
  • Importation
  • eRx
  • Medicare oversight payment reductions
  • Pay for reporting

Stand-alone Legislation
  • SCHIP Reauthorization
  • Coverage Initiatives
  • Insurance Regulation
  • FDA Overhaul/Rx safety
  • Physician Payment Reform
  • Care Management
  • Biogenerics
  • Personalized Medicine
  • Health IT/Privacy
  • AMP
  • ASP
  • Telemedicine

Comprehensive Legislation
  • Payment Reform
  • Medicaid Reform
  • Medicare Reform
  • Tort Reform
  • Tax Reform
  • Coverage Initiatives
  • Insurance Regulation

19
Active Engagement Building Relationships
  • Relationships with Government Officials Essential
    to
  • Protect the professions reputation
  • Get out in front of issues
  • Positively shape public policies
  • Position clinicians as subject matter
    experts/resources to government
  • Establish/Strengthen Relationships Before You
    Need Them
  • Encourage educational presentations
  • Provide background briefings on issues
  • Recommend solutions to healthcare concerns

20
Active Engagement Effective Advocacy
  • Relationships
  • Nurses and Physicians in Congress
  • Key committees
  • Representatives of your facility/area
  • Trade Associations
  • Issue Management
  • Identify, analyze, prioritize issues
  • Advocacy
  • Mobilize, organize, communicate

21
Extending Your LeadershipEngage and Influence
  • Understand key issues and positions
  • Stay abreast of pending legislation and
    association positions
  • Engage with elected officials, trade groups and
    coalitions on critical clinical issues
  • Offer to be a resource on healthcare issues
  • Lead by defining solutions for
  • Patient safety
  • Adoption of health IT
  • Efficiency
  • Quality improvement
  • Influence external organizations on clinical
    positions
  • VOTE!

22
QUESTIONS
23
Questions From Your Peers
  • What are the most critical issues to monitor in
    2009?
  • If the Democrats win the Presidency and the
    majority of the Congress, what issues will take
    center stage?
  • How will this scenario impact providers? Nurses?
    Physicians? Patients?
  • What are the most critical threats to the
    development of good healthcare public policy?
  • What can clinicians do individually and
    collectively to participate in setting new
    priorities? How and where should they start?
  • What are some best practices in public policy
    that can be used to improve healthcare?

24
Earn CEU Credits
  • For NURSING CE credit (ANCC), download the three
    forms at http//www.nursingleadershipcongress.com
    /ceu.asp
  • For PHYSICIAN CE credit (AME), please visit
    http//www.ceconcepts.net/NLC/
  • Complete forms and submit via online, mail or fax
    by November 5, 2008
  • Earn 1.0 hour of continuing education credit

25
Thank You!
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