Author Archives: Michele Foerst

ACA Repeal Efforts Stalled in Washington

by Blair Burnett, Policy Analyst, ACCC

U.S. Capitol

Despite much debate, healthcare reform remains in flux in Washington after a round of critical votes in the U.S. Senate this week. In the latest effort to repeal the Affordable Care Act (ACA), on Tuesday, July 25, the U.S. Senate voted 51-50, with Vice President Mike Pence breaking the tie vote, for a motion to proceed, which set up a process allowing for open debate and amendments to the AHCA, the House version of ACA repeal, on the Senate floor.

On Tuesday evening, the U.S. Senate brought to the floor their latest version of the Better Care Reconciliation Act (BCRA) with the added Cruz Amendment, allowing for sale of low-cost insurance plans if insurance policies that comply with the “essential services” provision of the ACA are also sold. The bill needed 60 votes to pass, but only received 43.

Debate continued Wednesday, July 26, and the U.S. Senate brought a repeal only bill to the floor, the Obamacare Repeal Reconciliation Act (ORRA), without language of a replacement effort. The vote, 45-55, showcased the lack of support among either party to vote for healthcare reform without actionable legislation.

As of Thursday, July 27, Senators were still in debate, bringing various amendments to floor for a vote. Late Thursday evening, a “skinny bill” was brought forth, that sought to roll back both the individual and employer mandate from the ACA. The text of this bill was not made available for public review, but besides repeal of the individual and employer mandate, left much of the ACA in place. When brought to a vote in the U.S. Senate, the bill failed, with a 49-51 vote in dissension of passage.

CBO estimates stated that the number of individuals insured would have decreased by 16 million by 2026 if the “skinny bill” were to pass and continue to become formal legislation. In the same time frame, the CBO estimates stated the federal deficit would have decreased by $142 billion, and premiums would have increased by an average of 20 percent.

For now, ACA repeal efforts and larger healthcare reform has stalled. More changes are certain to come from the Hill in the coming months as bipartisan healthcare reform legislation is expected to be drafted. Based upon the four pillars of ACCC’s health reform principles, a “skinny repeal” of the ACA would likely have destabilized current insurance markets, and placed increased burdens on cancer patients, specifically, elderly, low-income Americans accessing insurance in the individual and non-group markets. This week, ACCC joined over 30 other provider and patient groups to advocate against a skinny repeal of the ACA bill.

Senate Social Media Campaign - Skinny Repeal 7-27-17
As new legislation is brought forth, ACCC will continue to monitor and analyze impacts healthcare reform will have on cancer patients across the country.

ACCC members can gain an in-depth understanding of how CMS’ proposed CY 2018 Medicare rules will impact oncology by participating in ACCC’s August 9 webinar, “CMS Proposed 2018 OPPS & PFS Rules: What You Need to Know.” Learn more [member log-in required].

ACCC 33rd National Oncology Conference: “How To’s” for Patient-Centered Care

NOC 2016 Crowd

Attendees at the 33rd National Oncology Conference.

Nearly 600 attendees came together in St. Louis last week for the 33rd ACCC National Oncology Conference and companion pre-conferences. Across sessions the focus was on practical, proven “how to’s” for improving the delivery of patient-centered care in today’s challenging healthcare environment. Echoed throughout presentations were key messages for improving patient-centered care that apply regardless of cancer program size, structure, or geographical setting:

Listen to our Patients.

From a pre-conference Metastatic Breast Cancer Symposium to Thursday morning’s powerful opening session with speakers Niklaus and Lucy Steiner from the Be Loud! Sophie Foundation and Lauren Lux, LCSW, from the UNC Lineberger Comprehensive Cancer Center, to Friday morning’s inspiring session with New York Times columnist Suleika Jaouad, to the ACCC President’s theme panel on “Empowering Patients, Engaging Providers,” the message was loud and clear. Providers need to elicit and listen to the patient’s story.

“You’ve got to get to know the patients. . . . That’s something we’ve moved away from with [all of the] time constraints,” [Empowering Patients, Engaging Providers Panel].

“We have to take the time to ask the patients about [their] needs, wants, expectations…” [Empowering Patients, Engaging Providers Panel].

“You can’t have true patient-centered care unless you make the patient an active part of the conversation,” Suleika Jaouad.

Break Down Siloes.

To improve patient-centered care delivery, oncology needs to bridge existing healthcare siloes. This was the message in Anabella Aspiras’ conceptual talk on “Bringing the Cancer Moonshot Down to Earth” and the real-world experience described by ACCC 2016 Innovator Award winner Cone Health System, which described how to use data to identify “hot spotter” patients, assess gaps in care, and then connect across disciplines to improve care.

Connect with Existing Resources & Partnering Opportunities.

Innovator Award Winners

2016 ACCC Innovator Award Winners at the National Oncology Conference.

Multiple presenters focused on ways to connect and engage with community partners and resources to benefit the communities they serve. For example, Amy Montgomery and Robin Hearne, RN, from 2016 ACCC Innovator Award winner Outer Banks Hospital described steps to engage their county health department and school district leaders as strategic partners in a multi-faceted educational campaign that led to improved HPV vaccination rates for adolescents in their community.

Communicate. Communicate. Communicate.

It’s important to look for opportunities to improve communication not just outside the walls of the cancer program with primary care providers and other specialists, but within all members of the cancer care team. Explore strategies to leverage your program’s EHR to streamline information sharing among disciplines and team members.

Recognize the need for training for difficult conversations, not just between providers and patients, but internally among the oncology care team.

One-size-fits all communication does not work for a diverse population of cancer patients. In particular, it’s important to pay attention to opportunities to improve communication with underserved or under-recognized patient populations such as metastatic breast cancer patients and adolescent and young adult patients (AYAs).

Featured speakers addressing gaps in care for AYA patients provided practical suggestions for connecting with these young adults. In her dynamic, down-to-earth talk on “Helping AYAs BE LOUD,” Lauren Lux, LCSW, UNC Lineberger Comprehensive Cancer Center, shared that in communicating with AYAs it’s important to be:

  • authentic
  • flexible
  • compassionate
  • honest
  • willing to get to know the PERSON (who they are, what’s important, what drives them) and not just the PATIENT.

Be Ready for Culture Change.

On the business side, the culture shift to value-based payment reform is already underway.

From the patient perspective, the move is toward more patient-directed care. At the conclusion of Friday’s “Empowering Patients, Engaging Providers” discussion, panelists were asked what patient-centered care might look like in five years.

“I think patients want to get more involved with their biological information,” said ACCC President Jennie R. Crews, MD, MMM, FACP. “I think we’re going to see more patient insistence on ownership of the process.” Providers need to engage with patients as this culture shift is occurring, she said, as patients become more engaged, informed, and connected.

Upcoming blog posts will provider a closer look at takeaways from some key conference sessions. Stay tuned.