At the White House: ACA Implementation—An Opportunity to Advance Palliative Care

During my year as AAHPM President, I’ve had many opportunities to represent the Academy and have often been on Capitol Hill, looking to expand access to palliative care through the public policy process. On Dec. 17, the Obama administration held a meeting with community physicians at the White House to seek input about implementation of the Patient Protection and Affordable Care Act — the healthcare reform law. I was honored to be invited to attend and represent AAHPM members, as well as the other member organizations of the Hospice and Palliative Care Coalition (NHPCO, HPNA, CAPC, NPCRC and NASW).

This meeting—the first in a series—was hosted by Zeke Emanuel, MD, special adviser for health policy in the Office of Management and Budget (and brother of Obama’s former Chief of Staff Rahm) and the new CMS administrator, Don Berwick, MD, who provided a brief update on delivery system reform. The primary focus of the event, however, was to hold an open dialogue, so all participants were invited to come prepared with any questions or concerns they would like to raise. Much of the discussion focused on the launch of a new patient safety initiative and proposed rules for accountable care organizations (ACOs) participating in the Medicare program under the Affordable Care Act. I went on record stating the importance of palliative care in terms of improving quality of clinical care, improving family experience, and reducing cost. I urged inclusion of palliative care in the new ACO’s. (Read the Academy’s official comments to CMS regarding ACOs.)

There are many parts to the healthcare reform legislation, but many of the specifics are left to be defined through the rulemaking process. It will be important to see where the Academy can have the most impact by weighing in on these efforts. Last month, AAHPM joined with its Coalition partners in providing comments to the Institute of Medicine as it studies the Essential Health Benefits outlined in the Affordable Care Act. The Coalition urged officials to ensure that palliative care and hospice care are defined as essential components of all insurance plans offered under the government’s exchange, in order to deliver quality care for the nation’s sickest and most vulnerable patients. I’ll have a chance in January to speak to the IOM Committee working to define these benefits.

While I am pleased to be the voice of AAHPM’s membership, mine is not the only voice that officials want to hear. We’ve come to learn that they are looking to see not only which folks but how many folks are weighing in on these issues as a guide to how significant an issue may be. When there are opportunities for public comment that AAHPM has identified as an avenue to advance palliative care and hospice, we’ll include the details in e-News. I encourage you to follow up on these alerts. And don’t forget that you can always weigh in on legislative matters as well, directly contacting your representatives in Congress using AAHPM’s Legislative Action Center.

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