Advocacy Marci Neilson, PhD, MPH CEO, Patient-Centered Primary Care Collaborative 2:30 PM

2. AdvocacyMarci Neilson, PhD, MPHCEO, Patient-Centered Primary Care Collaborative2:30 PM Evolution of the PCPCC, the Patient-Centered Medical Home, and Advocacy

3. The Four Camps of Leadership in Health Care Policy Greater Resiliency Lower Lower Greater Understanding

4. About PCPCC – or “the Collaborative” Our Mission • Dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home. Activities • Strengthening public policy that advances and builds support for primary care and the medical home • Disseminate results and outcomes from medical home initiatives and their impact on outcomes, quality and costs • Convene health care experts and patients to promote learning, awareness, and innovation of primary care and the medical home

5. History of PCPCC National not-for-profit coalition founded in 2006 to: • Facilitate achievements toward the Triple Aim: better health, better care experience, and health care cost control • Create a more effective and efficient model of healthcare delivery, grounded in primary care Acts as conveners to bring together thought leaders and stakeholders to address challenges, opportunities, and barriers to health system transformation • Contributed to developing PCMH language for health reform proposals • Published dozens of reports

6. Membership Since 2006, PCPCC membership has grown to represent more than 1,000 organizations providing care to 50 million Americans, including: • Provider associations • Large employers • Health plans • Providers & health systems • Pharmaceutical firms • Policymakers • Patient advocacy groups

7. PCPCC Resources

8. Role of the Collaborative • Challenge the status quo and drive the marketplace • Disseminate timely information and evidence • Provide networking & educational opportunities

9. Board of Directors Employer & Purchaser Engagement Center Care Delivery and Integration Center Patient, Family & ConsumerCenter Advocacy & Public Policy Center Outcomes & Evaluation Center Taskforces Special Interest Groups Event Planning (Annual Mtgs) Publications PCPCC Org Chart Finance Committee Operations Committee Executive Committee 9

10. State and Federal Public Policy

11. Patient = Consumer = Voter IOM (2002); modified from Dahlgren and Whitehead (1991)

13. Longest Model of Public Policymaking Preferences of individuals, organizations, and interest groups, along with biological, cultural, Demographic, ecological, economic, ethical, legal, psychological, social and technical inputs Policy Formulation Phase Policy Implementation Phase Policy • Agenda Setting • Problems • Possible Solutions • Political • Circumstances Development of Legislation Operation Formal Enactment Of Legislation Rulemaking Window of opportunity Policy Modification Phase Feedback from individual, organizations, and interest groups experiencing the consequences of policies, combined with the assessments of the performance and impact of policies by those who formulate and implement them, influences future policy formulation and implementation

14. Advocacy and Public Policy Center Activities & Priorities The Advocacy & Public Policy Center is dedicated to working closely with policymakers, agencies and government leaders at the state and federal levels to drive health system reform that incorporates key features of the medical home. The Center shapes PCPCC’s policy and advocacy agenda and works with health care stakeholders to support meaningful policies related to Accountable Care Organizations, health insurance exchanges, health information technology, and payment reform.

15. Center Activities • Develop communication tools that enhance public awareness for primary care, the medical home and key advocacy issues • Advocate for the development of public policies that strengthen primary care and the medical home • Educate state and federal policymakers about the cost-saving and care delivery impact of primary care and the medical home • Gather and disseminate evidence that demonstrates medical home impact on Triple Aim goals • Work collaboratively with other centers to develop a strategic public policy agenda

16. Leadership of Cabinet Co-Chairs : • Shari M. Erickson, MPH • Vice President, Governmental and Regulatory Affairs, American College of Physicians • Greg Pawlson, MD, MPH, FACP • Senior Medical Analyst, Stevens & Lee

17. Cabinet members(1) • State Government Affairs Analyst, American Academy of Pediatrics • Director, Federal Affairs, National Committee for Quality Assurance • Senior Policy Advisor, American Psychological Association • Vice President, Clinical Programs and Behavioral Health, Amerigroup/WellPoint • Associate Director, Federal Affairs, American Academy of Pediatrics • Director, Policy & Government Relations, Kaiser Permanente • Senior Associate, Legislative Affairs, American College of Physicians • Executive Director, Alliance for Home Health Quality and Innovation • Vice President, Advocacy and Practice Advancement, American Academy of Family Physicians • Senior Manager, Marketing and Healthcare Policy, Lumeris • Associate Director, Government Affairs, American College of Clinical Pharmacy • Director, Federal Affairs, American Congress of Obstetricians and Gynecologists • Director, Center for Health Policy Research and Ethics, George Mason University

18. Cabinet members (2) • Professor of Public Policy, Departments of Psychiatry and Public Health, Family Medicine, Oregon Health and Science University • Director, Government Relations, American Osteopathic Association • Vice President, Nursing Services and Excellence, InnovAge • Senior Advisor, Center for Value-Based Insurance Design, University of Michigan • Program Director, National Academy of State Health Policy (NASHP) • Director of Health Policy/Federal Government & Professional Affairs, American Academy of Nurse Practitioners • Senior Policy and Government Affairs Analyst, American Academy of Pediatrics • Director of Health Partnerships and Policy, YMCA of the USA • Director, Regional Alliances and State Government Affairs Analyst, Sanofi • President and Chief Executive Officer, National Coalition on Health Care • Senior Director, Policy and Strategic Advocacy, Sanofi • Head of Public Policy, Thermo Fisher Scientific • Executive Director, American Psychological Association

19. Role of The Collaborative (PCPCC) • Lead from the front • Challenge the status quo • Drive the marketplace • Disseminate timely information • Provide networking & educational opportunities

20. Advocacy statements • 11/12/2013 -- PCPCC Responds to Latest SGR Proposal from Senate Finance and House Ways & Means • 09/30/2013 -- Mental Health and Primary Care Integration - PCPCC Letter to Senate Finance Committee • 08/01/2013 -- PCPCC Extends Support for Bipartisan House 'Doc Fix' Bill (Press Release) • 07/22/2013 -- PCPCC Supports Draft Legislation to Repeal SGR and Reform Medicare Physician Payment (Press Release) • 07/18/2013 -- PCPCC Statement to Senate Finance Committee in Support of Health Care Payment Reform (Press Release) • 12/03/2012 -- PCPCC Leadership Responds to Latest Medical Home "Systematic Review" • 04/11/2012 -- PCPCC commends federal Comprehensive Primary Care Initiative: Effort will bring payers and providers together to advance patient-centered primary care

21. Advocacy/education efforts • Legislative branch • Need for evidence that the PCMH works • briefings, letters, visits, materials • Need for technical assistance on features of the PCMH • Payment reform (SGR fix), behavioral health integration, recognition/certification programs • Tools for legislators/stakeholders to describe PCMH • Executive branch • Tracking and highlighting CMMI pilots • FEHBP, Medicare, Medicaid, Military • Publicizing success stories – case studies, webinars, meetings

22. Q and A • What are the PCPCC lessons learned that translate to Colorado? • Buy-in • Transparency • No surprises • Which constituencies are missing from your collaborative that can help you advocate effectively? • How will you decide on your priorities and not suffer from mission creep?

23. Contact: Marci Nielsen, PhD, MPH Chief Executive Officer mnielsen@pcpcc.net www.pcpcc.net