About Care Continuum Alliance Advocacy
Policymakers know the Care Continuum Alliance as the voice of wellness, prevention and population health management and care and turn to Care Continuum Alliance member leaders and staff for the information and resources they need to guide the decision-making process. Through its Government Affairs Committee, the Care Continuum Alliance answers that call with expertise that contributes to the process, while always protecting the interests of its members.
The Committee, open to all association members, works to support state and federal legislative initiatives that promote evidence-based population health improvement. At the federal level, the Care Continuum Alliance responds to emerging legislative proposals and regulatory policies of potential consequence to its members and other stakeholders. The Care Continuum Alliance also works with state lawmakers and regulatory officials, educating them on the effectiveness of population health improvement and its benefits to Medicaid and other populations.
Advocacy Accomplishments in 2010
As health care reform moved from legislation to regulation in 2010, the Care Continuum Alliance marshaled its member and staff expertise to identify and promote opportunities for wellness, prevention and chronic care. Quality improvement provided a unifying theme for Care Continuum Alliance advocacy, as well as the potential of population health management to add value to new delivery and reimbursement models.
Medical Loss Ratio
Care Continuum Alliance advocacy dating to 2006 planted seeds of change that bore fruit in 2010: recognition of wellness, prevention and care management as quality improvement activities in medical loss ratio (MLR) calculations.
The Care Continuum Alliance actively sought the change, first through National Association of Insurance Commissioners (NAIC) accounting guidance and then last year, as part of NAIC work to implement insurance market reforms in the Patient Protection and Affordable Care Act (ACA). Among them: creation of an “activities that improve health care quality” category to join existing medical and administrative cost categories in the MLR formula.
In late October 2010, the NAIC recommended to the Secretary of Health and Human Services that population health management fall under the quality improvement definition. The federal government followed suit in December 2010 with an interim final rule consistent with that recommendation.
Throughout the process, the Care Continuum Alliance:
Supporting Wellness and Prevention
The Care Continuum Alliance made the industry's voice heard in the 2009 debate over health care reform legislation and again last year, as the bill became law and entered the regulatory process. In frequent communications to and meetings with lawmakers and regulators and its work as part of the Patient-Centered Primary Care Collaborative, Partnership to Fight Chronic Disease and other coalitions, the Care Continuum Alliance vigorously promoted wellness and prevention.
It carried that message to Capitol Hill, where, in a July 2010 briefing for congressional staff and the media, the Care Continuum Alliance, American College of Preventive Medicine and U.S. Preventive Medicine spoke to a standing-room-only audience about groundbreaking new Medicare wellness and prevention benefits in the reform law. The presentation underscored the importance of health risk assessments and potential of the new benefits to improve beneficiary health and lower program costs.
Meaningful Use of Health Information Technology
Sharing the stage with health care reform in 2010 was work to carry out provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the 2009 economic stimulus law. The HITECH Act allowed for monetary incentives to providers and hospitals for "meaningful use" of HIT, including for coordinating care, increasing patient and family engagement and improving population and public health. The Care Continuum Alliance weighed in on the development of meaningful use regulations for Stage 1, in addition to recommending concepts and domains for stages 2 and 3 of the criteria; recommendations included quality measures for the proposed domains. The Care Continuum Alliance leveraged the expertise of its HIT Committee and technology experts among its membership.
Other Advocacy Accomplishments
Also in 2010, the Care Continuum Alliance: