ACCP-PAC PRN Participation Challenge

Consistent with the priorities set out in ACCP’s strategic plan and the College’s organization-wide commitment to clinical practice transformation, ACCP’s Washington, D.C., office has been focused for almost 3 years on an advocacy effort that calls on Congress to enact legislation to provide Medicare patients with coverage for comprehensive medication management (CMM) within the Part B medical benefit.

Central to our grassroots advocacy strategy, ACCP staff have worked to engage with our PRN leaders and identify opportunities through PRN meetings and communications to stimulate discussion, interest, and grassroots advocacy on behalf of our Medicare Initiative.

Now we are specifically calling on PRN members to demonstrate their commitment to the College’s advocacy priorities through contributions to ACCP’s Political Action Committee (ACCP-PAC).

How the Challenge Works

ACCP-PAC has launched a competition (the ACCP-PAC PRN Participation Challenge) to determine which PRN provides the greatest PAC support. When PRN members make a PAC contribution online, they are provided with an option to designate a PRN to receive credit for their contribution. Over time, we will determine which PRN provides the greatest PAC support.

• The challenge will be measured with respect to the percentage of PRN members who contribute to the PAC, not the total dollars raised by each PRN.
• ACCP members who belong to several PRNs can make multiple contributions in the name of each PRN, but only one PRN can receive credit for any single contribution.

PRN officers are urged to encourage members of their PRNs to participate in the challenge and support ACCP-PAC. All contributions, no matter how small, count toward the challenge, but we suggest that PRN members contribute at least $25 to this effort. Please take the time to highlight the challenge in PRN meetings and online communications to PRN members. The leading PRN will receive recognition on the ACCP website, in communications from the Washington office, and at the 2015 ACCP Global Conference on Clinical Pharmacy in San Francisco. For more information, contact John McGlew ([email protected] or (202) 621-1820).

More About ACCP-PAC

ACCP-PAC is the only means by which ACCP can provide financial support to help candidates to Congress who understand and support our issues and share our vision of a team-based, patient-centered, quality-driven approach to health care delivery.

ACCP-PAC is nonpartisan and supports elected officials, regardless of their political party affiliation. ACCP-PAC is regulated by the Federal Election Commission (FEC) based in Washington, D.C. The PAC files quarterly FEC reports declaring all PAC receipts and disbursements, which are publically available at www.fec.gov.

Because of FEC regulations, PAC contributions are NOT deductible as charitable for federal tax purposes and must be made by personal funds and/or post-tax dollars. Unlike contributions to the Frontiers Fund, ACCP-PAC cannot accept contributions directly from PRNs. All PAC contributions must be made by individuals from personal funds.

Who Receives ACCP-PAC Support?

All decisions regarding financial contributions to candidates are made by the PAC Governing Council according to certain established criteria:

• Position on key health care committees in Congress
• Proven support for pharmacy and health care–related issues
• Previous health care experience

The key health care–related committees in Congress are the Appropriations, Ways & Means, and Energy & Commerce committees in the House of Representatives and the Appropriations Committee, Finance Committee, and Health, Education, Labor & Pensions (H.E.L.P.) Committee in the Senate.

ACCP members who contribute to the PAC may recommend candidates to receive contributions. All PAC contributor recommendations will be considered; however, we may not accommodate all requests. The ACCP-PAC Governing Council must approve all candidate contributions.

ACCP-PAC can only contribute to candidates who are running for federal office (candidates for the U.S. House of Representatives or the U.S. Senate, not state legislatures or gubernatorial races).

Why Support ACCP-PAC?

• The success of ACCP-PAC depends entirely on the support of our membership, because we can only solicit contributions from ACCP members.
• Because ours is the only PAC registered on behalf of clinical pharmacy, this is a unique opportunity to raise our political profile and advance our advocacy agenda.
• Political contributions help raise our profile in Washington, D.C., and attending fundraising events offers an additional opportunity to build relationships with members of Congress or congressional staff.
• ACCP members can also attend fundraising events on behalf of the PAC and help improve their relationships with elected officials.
• By combining individual contributions from ACCP members into a larger pool of money, ACCP-PAC can maximize the impact of the support we provide to candidates who fight on behalf of the profession.
• ACCP pays the administrative costs of running the PAC, so all money raised goes directly toward helping elect pro–clinical pharmacy candidates to federal office.

For more information, visit the ACCP-PAC website at www.accpaction.com.

Updates from Washington, D.C. – Health Care Legislation Picks Up Steam in Congress

Earlier this year, President Barack Obama signed into law legislation permanently repealing the flawed Medicare SGR (sustainable growth rate) formula. The passage of this legislation not only represents an important bipartisan success story in what appeared to be an otherwise hopelessly deadlocked Congress, but also opened the door to a new approach to Medicare payment policy that rewards quality and outcomes over value and supports alternative payment models such as accountable care organizations and patient-centered medical homes. Under the new payment model, a merit-based incentive payment system (MIPS) will be established beginning in 2019, which includes a combined value-based payment program that assesses the performance of each eligible provider on the basis of quality, resource use, clinical practice improvement activities, and meaningful use of certified electronic health record technology.

The SGR was originally established in 1997 as a means for the Centers for Medicare & Medicaid Services (CMS) to regulate spending on Medicare physician services by linking payment levels to economic growth. In practice, cuts mandated under the formula were never implemented as Congress stepped in to defer or “patch” the payment methodology.

That congressional Democrats and Republicans were finally able to find common ground on a complicated and controversial policy area and produce a piece of legislation that met with the approval of a president who has been criticized for his inability to work with his congressional counterparts is, of course, an important development in its own right. But perhaps more important is the opportunity that the SGR repeal package offers for future health care policy developments, including ACCP’s Medicare Initiative.

ACCP is confident that its Medicare Initiative is consistent with the overall structure of this payment approach, and we will continue to work with our friends and allies on Capitol Hill to integrate coverage for CMM services within the evolving Medicare program.

21st Century Cures

Shortly after President Obama signed the SGR repeal package into law, health policy leaders in Congress refocused their efforts on an initiative aimed at accelerating the discovery, development, and delivery of promising new treatments and cures for patients and maintaining America’s standing as the biomedical innovation capital of the world. This initiative, called the “21st Century Cures Act,” is the culmination of more than a year’s worth of public conversation with patients, innovators, providers, regulators, consumers, and researchers about what steps Congress can take to bridge the gap between advances in science and medicine and how those therapies are regulated. Citing the fact that treatments exist for only 500 of the 10,000 known diseases (7000 of which are rare), 21st Century Cures aims to:

• Bolster resources for the National Institutes of Health and help encourage young and emerging scientists
• Develop policies to unlock the wealth of data available today to help further research and innovation
• Modernize clinical trials and fully realize the promise of personalized medicine
• The legislation was approved by a margin of 51-1 at a full hearing of the House Energy and Commerce Committee. Policy leaders are hopeful that the proposal will eventually be signed into law by the end of 2015.

Click here to view H.R. 6, the 21st Century Cures Act, in full.

Click here to read a one-page discussion draft.

Chronic Care Initiative

On May 22, Finance Committee Chairman Orrin Hatch (R-UT) and Ranking Member Ron Wyden (D-OR) issued a letter to health care stakeholders announcing the formation of a bipartisan congressional working group to begin exploring solutions that will improve outcomes for Medicare patients requiring chronic care. This announcement followed a May 15 Senate Finance Committee hearing on the issue. Senate Finance Committee members Johnny Isakson (R-GA) and Mark Warner (D-VA) have been nominated to lead the effort, which will examine the following issue areas:

• Improvements to Medicare Advantage for patients living with multiple chronic conditions
• Transformative policies that improve outcomes for patients living with chronic diseases either through modifications to the current Medicare Shared Savings ACO Program or piloted alternative payment models (APMs) currently under way at CMS, or by proposing new APM structures
• Reforms to Medicare’s current fee-for-service program that incentivize providers to coordinate care for patients living with chronic conditions
• The effective use, coordination, and cost of prescription drugs
• Ideas to effectively use or improve the use of telehealth and remote monitoring technology
• Strategies to increase chronic care coordination in rural and frontier areas
• Options for empowering Medicare patients to play a greater role in managing their health and meaningfully engaging with their health care providers
• Ways to more effectively use primary care providers and care coordination teams in order to meet the goal of maximizing health care outcomes for Medicare patients living with chronic conditions

The response to the committee’s request for input was overwhelming—more than 530 submissions from interested stakeholders across the country provided ideas on ways the Medicare program can better deliver health care to beneficiaries with multiple chronic illnesses. Senate leadership reacted positively to the response from the health care community. In a statement released by Hatch and Wyden, the senators commented, “We appreciate the input from members of the health care community and are thrilled so many weighed in on this important bipartisan issue. We also applaud Senators Johnny Isakson and Mark Warner for their hard work in leading this initiative. Their efforts represent a strong bipartisan desire to find real solutions that provide high quality medical care to Medicare patients, at greater value and lower cost, without adding to the deficit. We look forward to partnering with our colleagues to review the submissions as we work toward a common goal of developing bipartisan legislative solutions this Congress.”

ACCP Comments to the Bipartisan Working Group

In response to the request for input, ACCP, together with its Medicare Initiative partner, the College of Psychiatric and Neurologic Pharmacists (CPNP), submitted a joint statement to the committee. The statement addressed several key issue areas that outline specific policy categories the committee plans to consider as part of its chronic care reform efforts:

• The Effective Use, Coordination, and Cost of Prescription Drugs
• Ideas to Effectively Use or Improve the Use of Telehealth and Remote Monitoring Technology
• Strategies to Increase Chronic Care Coordination in Rural and Frontier Areas
• Ways to More Effectively Utilize Primary Care Providers in Order to Meet the Goal of Maximizing Health Care Outcomes for Medicare Patients Living with Chronic Conditions

In the comment letter, ACCP and CPNP urged the committee to focus on care delivery models that promote and incentivize a truly patient-centered and interprofessional approach to medication-related clinical care and medication safety. The comments called on the committee to advance a quality-focused, patient-centered, team-based approach to health care delivery that helps ensure the safety of medication use by patients and that achieves medication-related outcomes aligned with patients’ overall care plans and goals of therapy through the provision of comprehensive medication management (CMM).

As part of the process of reforming the Medicare payment system, ACCP and CPNP urged Congress to enact reforms to the Medicare program that provide for coverage of CMM services provided by qualified clinical pharmacists as members of the patient’s health care team within its broader payment reform efforts and extended an offer to the committee to provide further information, data, and connections with successful practices that provide CMM services to help further inform the committee about this service in the context of Medicare payment and delivery system improvements that will modernize and sustain the program for the future.

Click here to read the ACCP/CPNP comments in full.

Earlier, ACCP submitted comments related to the May 14 Senate Finance Committee hearing titled “A Pathway to Improving Care for Medicare Patients with Chronic Conditions.”

Click here to read the comments in full.

Additional Opportunities for CMM

As evidence of the growing recognition within the health care policy community of the importance of CMM as part of the process of developing and implementing policies designed to streamline care coordination, improve quality, and lower Medicare costs, ACCP has learned that several organizations also included calls for CMM coverage in their comments to the committee. These organizations include the Pharmaceutical Research and Manufacturers of America (PhRMA), the Biotechnology Industry Organization (BIO), GlaxoSmithKline (GSK), Blue Thorn Inc., and Healthcare Consulting. During the coming weeks, ACCP staff will continue to review the comments submitted to the Senate Finance Committee to identify other organizations advocating for Medicare coverage for CMM services.

Outlook for the Chronic Care Initiative

In conversations with staff from the offices of many of the key leaders in the Senate Finance Committee bipartisan working group on chronic care, ACCP has learned that Senate leadership—drawing from the input provided by stakeholders—aims to develop legislative language during the next few months and hopes to have a draft bill in place by the end of 2015. By congressional standards, this represents relatively rapid movement on this issue and provides a significant opportunity for ACCP to advance its Medicare Initiative. ACCP members should be prepared to engage with their elected officials during the coming months to help ensure the inclusion of a CMM component as part of the legislative package that emerges from this process.

Summary

These encouraging developments, combined with ongoing conversations with key policy leaders on Capitol Hill, provide grounds for optimism for the success of our Medicare Initiative. We recognize the challenging political and economic environment in which we are operating, and we have always made it clear that achieving our goals will be a long-term undertaking. That said, our efforts to date have brought together a growing, bipartisan group of lawmakers who recognize the value of a truly team-based, patient-centered approach to health care and understand that “getting the medications right” through a consistent care process is a vital component of evolving payment and delivery models. In focusing on coverage for a defined process of care that differentiates the practice of the clinical pharmacist (CMM) from the practices of other members of the health care team and fills a need that is unmet through the existing processes of care, we are confident that our proposal is both structurally sound and demonstrably aligned with emerging Medicare payment policy reforms.

Advancing Our Medicare Initiative Through Grassroots Action

We believe that our investment in our Washington office and advocacy activities, combined with the traction that health care issues are gaining in Congress, leaves us well placed to advance our Medicare Coverage Initiative. But our success ultimately lies in the engagement of ACCP members to help their elected officials understand the importance of “getting the medications right” as part of patient-centered, team-based models of care delivery.

With more than 16,000 members, not to mention their professional colleagues and patients, ACCP has the potential to exert considerable influence on Capitol Hill. But to realize this potential, we need the active participation of all our members as grassroots advocates.

Identifying Political Champions

In seeking to identify potential champions to advance our initiative in Congress, we need to identify elected officials who share our vision of a more patient-centered, team-based, and quality-focused approach to Medicare who also sit on the congressional committees of jurisdiction over the Medicare program itself.

In the House of Representatives, jurisdiction over Medicare is shared between the Energy and Commerce Committee and the Committee on Ways and Means. In the Senate, the Finance Committee oversees Medicare issues. Members who sit on these committees are best placed to introduce legislation on behalf of ACCP and work to ensure its passage into law.

Click here to view the members of the Senate Finance Committee.

Click here to view the members of the House Energy and Commerce Committee.

Click here to view the members of the House Ways and Means Committee.

To determine whether your elected officials sit on a committee of jurisdiction, visit our Legislative Action Center and enter your zip code to view your congressional delegation. Check your work zip codes as well as your home address—especially if you practice in multiple sites. Members of Congress will be interested to learn about innovative, cost-saving care delivery going on in their district, even if you are not a constituent residing in that district.

ACCP’s Guide to Hosting a Visit of Elected Officials to Your Practice

Hosting a visit of your elected officials to your practice is perhaps the single most important thing you can do to help lawmakers understand what team-based, patient-centered clinical practice is all about—and to generate their support for recognition and payment for clinical pharmacists’ services.

A visit also serves as a means to establish an ongoing constructive dialogue with your congressman or senator, and their staff, on issues important to the delivery of team-based, patient-centered care.

A comprehensive guide to inviting a member of Congress to tour your practice site is available on our Legislative Action Center. If you would like to discuss the process of hosting a lawmaker at your practice site, please contact John McGlew at (202) 621-1820 or [email protected].

All ACCP members are urged to consider inviting their elected officials to learn more about their practice through a tour of their practice site.

Contact Us! For more information on any of ACCP’s advocacy efforts, please contact:

John K. McGlew
Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Avenue NW
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]