U.S. House of Representatives Congressional Briefing
“‘Getting the Medications Right’: An Essential Ingredient in Achieving the Goals of H.R. 4878 – the Medicare Better Care, Lower Cost Act”
On May 18, 2016, in the Rayburn House Office Building on Capitol Hill, Representatives Eric Paulsen (R-MN) and Peter Welch (D-VT) hosted a congressional briefing titled “‘Getting the Medications Right’: An Essential Ingredient in Achieving the Goals of H.R. 4878 – the Medicare Better Care, Lower Cost Act.”
The briefing was originally proposed during a meeting held by ACCP with Paulsen’s office. His staff inquired whether the College could help identify appropriate pharmacist-physician teams and invite them to Washington to present how comprehensive medication management (CMM) services, delivered under team-based care structures, can significantly improve patient outcomes and control health care costs. The focus and content of the proposed briefing were consistent with Paulsen’s efforts to advance the Better Care, Lower Cost Act (H.R. 4878), and the joint initiative confirms the strength of the relationship ACCP is building with Paulsen. ACCP was joined in this briefing by the College of Psychiatric and Neurologic Pharmacists (CPNP), ACCP’s long-standing partner in its Medicare Initiative.
In keeping with efforts to maintain a bipartisan approach on this initiative, ACCP reached out to the other original cosponsor of H.R. 4878, Democratic Congressman Welch, who enthusiastically agreed to serve as a briefing cohost.
ACCP’s relationship with these health care policy leaders began in 2014, when the College endorsed their legislation during the 113th Congress, when it was first introduced. Before its reintroduction earlier this year, Paulsen and Welch contacted ACCP staff in Washington to reestablish this dialogue. In response, ACCP submitted comments confirming the College’s ongoing support for the bill.
About the Better Care, Lower Cost Act
The Better Care, Lower Cost Act is aimed at improving care for chronically ill Medicare beneficiaries and reforming the fee-for-service system to facilitate team-based care that helps patients achieve their clinical goals. The bill would establish a “Better Care Program,” offering traditional Medicare enrollees facing multiple chronic conditions the option to receive care tailored to their needs and preferences delivered by collaborative teams of health care professionals.
The bill includes pharmacists as eligible members of the proposed “better care practices,” which would expand opportunities for Medicare beneficiaries to participate in integrated care delivery models, but does not specify what pharmacists would do as part of these teams. In its endorsement letter, ACCP urged Paulsen and Welch to go beyond simply including pharmacists on the list of providers by enacting reforms to the Medicare Part B program that grant coverage of CMM services provided by qualified clinical pharmacists as members of the patient’s health care team.
Briefing Purpose and Goals
The briefing highlighted contemporary care delivery approaches to achieving medication optimization through formalized interprofessional practice structures composed of physicians and other health professionals providing direct patient care in collaboration with clinical pharmacists. This approach is increasingly recognized as essential for “getting the medications right” for patients, particularly those with complex and/or multiple chronic conditions and care needs.
Expansion and scaling of practices that can accomplish medication optimization and help patients reach clinical goals through medication therapy is consistent with several of the policy goals contained in H.R. 4878. Specifically, the bill seeks to improve the quality and coordination of care for beneficiaries by supporting enhanced care coordination across Medicare Parts A, B, and D through promotion of patient-centered “better care programs,” interprofessional practice and education support, and enhanced use of health information technology.
The Briefing Panel
“The Briefing Panel seated in the Rayburn House Office Building”
From left to right: Mary M. Figueroa, M.D.; Amanda Brummel, Pharm.D., BCACP; C. Edwin Webb, Pharm.D., MPH, FNAP; Charles D. MacLean, M.D.; and Amanda Kennedy, Pharm.D., BCPS
True to the adage that “all politics is local,” ACCP has worked to identify practitioners from the representative’s home states.
Minnesota Presenters:
- Amanda Brummel, Pharm.D., BCACP
Director, Clinical Ambulatory Pharmacy Services
Fairview Health Services
Minneapolis, MN
- Mary M. Figueroa, M.D.
Family Physician
Fairview Southdale Hospital
Edina, MN
Vermont Presenters:
- Amanda Kennedy, Pharm.D., BCPS
Pharmacist Clinician
University of Vermont Medical Center
Burlington, VT
- Charles D. MacLean, M.D.
Associate Dean for Primary Care and Professor of Medicine
University of Vermont Medical Center
Essex Junction, VT
Presentation Overview
Minnesota Collaborative Team
The Minnesota practitioner team presented an overview of Fairview Health Services, a nonprofit partnership with the University of Minnesota that delivered 6.6 million patient encounters at more than 30 CMM practices in 2015.
Highlighting the extent of the medication use problem within the U.S. health care system, Brummel and Figueroa described the spectrum of pharmacist practice and explained how consistent, defined, collaborative process of care is delivered to patients treated at Fairview Health Services. Of particular importance to the health policy audience, the presentation also focused on economic and outcomes data, including a crucial proven 12-to-1 return on investment in reduced overall health care costs.
Vermont Collaborative Team
Members of the Vermont team provided an overview of their work under the Vermont Blueprint for Health, a state-led, nationally recognized initiative transforming the delivery and payment of primary care and comprehensive health services. The program includes multi-payer payment reform with financial incentives, community health teams to augment primary care, quality improvement infrastructure, health information technology for treating individuals and populations, and collaboration with accountable care organizations and patient-centered medical homes.
Kennedy and MacLean went on to describe the demonstration project they worked under, aimed at improving care by optimizing medication regimens, or “getting the medications right,” in primary care through a mix of education, direct patient care, and population-based medication management.
Click here to view the presentations in full.
Summary
Congressional briefings are hosted by members of Congress in collaboration with key stakeholders on a particular issue area. Briefings are generally open to the public, but their target audience is other congressional offices, with the goal of educating staff members and building awareness and support to help advance the issue legislatively.
On the basis of these criteria, ACCP’s briefing was an unqualified success, widely attended by a diverse group of congressional staff and other interested parties. ACCP and CPNP would like to thank Brummel, Figueroa, Kennedy, and MacLean for the time spent preparing, traveling, and presenting at the briefing, which ensured the success of this important event. In addition, ACCP is grateful to the offices of Paulsen and Welch for their ongoing commitment to improving quality, care delivery, and outcomes for Medicare beneficiaries and their recognition that, to achieve this goal, it is vital to “get the medications right.”
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 Ave NW
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]