Since the passage of the Patient Protection and Affordable Care Act (PPACA), the National Health Council (NHC) has identified the following priority areas on which to focus
- The essential health benefits package
- Health care reform implementation
- Comparative effectiveness research
- Delivery system reform
PPACA includes language that directs the Secretary of Health and Human Services to develop a package of health care services that all qualified health plans must reimburse for their covered beneficiaries. This essential health benefits (EHB) package will serve as a baseline for insurance providers. The NHC is committed to ensuring that the Secretary develops a package that best meets the needs of people living with chronic diseases and disabilities. To that end, the NHC researched what the costs of a "typical" benefits package might be and developed recommendations and proposed regulatory language that it has shared with the Secretary’s staff.
In February 2013, the Department of Health and Human Services issued a final rule outlining policies that will give states flexibility to create an EHB package to meet local needs.
- A simple counting approach to decide on medications covered by state exchanges will limit patient access to medications. Read the NHC’s letter to Secretary of Health and Human Services Kathleen Sebelius.
- NHC gathers signatures from more than 100 patient and health care provider organizations urging the Administration to change its policy on out-of-pocket costs that will be charged people with chronic conditions in 2014
- NHC Director of Government Affairs Eric Gascho talks about how Essential Health Benefits may change under the Affordable Care Act. His presentation begins approximately 29 minutes into the webinar (May 1, 2013)
In its continuing effort to provide a united voice for people with chronic diseases and disabilities, the NHC sent the following comments to Congress and the Administration:
- NHC comments on the Centers for Medicare & Medicaid Services (CMS) request for information regarding health care quality for exchanges (December 21, 2012)
- NHC comments on the on the pre-regulatory regulation, “Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation.” (December 19, 2012)
- Joint letter to Health and Human Service (HHS) Secretary urging the inclusion of patient protections and a robust formulary in the EHB package (October 2, 2012)
- NHC position statement on EHB Formulary (August 10, 2012)
- NHC letter to select members of the House of Representatives on EHB formulary design (July 27, 2012)
- NHC comments on HHS proposal for data collection to support standards related to EHBs (July 5, 2012)
- Joint letter to HHS Secretary Sebelius on the proposed EHB prescription drug formulary (April 11, 2012)
- NHC comments on the CCIIO EHBs (April 10, 2012)
- NHC comments on the CCIIO EHB guidance bulletin (January 23, 2012)
- Briefing handout on EHBs and the need for federal oversight (January 20, 2012)
- Slides from NHC Capitol Hill briefing on EHBs (January 20, 2012)
- NHC memorandum to CCIIO describing the suggested framework for determining EHBs (December 19, 2011)
The National Health Council has hosted a series of webinars for patient advocate organizations to help them prepare people with chronic diseases and disabilities for the opening of the health care exchanges. The NHC has also worked with Avalere Health to develop tools for these organizations to assist with the enrollment process. Click here.
On July 9, 2012, the NHC held a briefing on the Supreme Court's decision upholding the constitutionality of the Affordable Care Act (ACA). Below are links to the video presentations. To view the presentation slides, please click here.
- Opening Statement and Overview of the Supreme Court Decision and Current Environment
- Impact on the Health Community and How to Meet Patient Needs
- Next Steps for the Patient Community to Address Implementation
During the debate over health care reform, the NHC sent the following comments to Congress and the Administration:
- Group sign-on letter to HHS requesting the creation of an out-of-pocket cost estimator for patients comparing health insurance plans in the health insurance marketplaces (October 9, 2013)
- Group sign-on letter to the HHS Office of Human Rights, requesting careful monitoring of the impact of specialty tiers on patients with chronic conditions (September 30, 2013)
- NHC comments to HHS on the proposed rule "Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium Stabilization Programs, and Market Standards" (July 22, 2013)
- Patient advocacy organizations and the Supreme Court decision on the Affordable Care Act (April 5, 2012)
- NHC unites patient advocacy community to show solidarity in support of the Affordable Care Act (March 27, 2012)
- (September 28, 2011)
- NHC comments on the proposed rule implementing accountable care organizations under the CMS Medicare Shared Savings Program as outlined in the PPACA (June 6, 2011)
- NHC letter to the Senate supporting the efforts of Congress to enact meaningful health care reform that will benefit the patient community (March 24, 2010)
- Values to Ensure Patient-Focused Health Care Reform
Comparative effectiveness research (CER) is the concept of evaluating evidence on the relative medical benefits and costs of various treatments to identify the most effective one for any given diagnosis. The NHC has advocated for conducting CER in a way that is transparent and involves input from the patient community during every step of the process. Furthermore, the NHC advocates for the scope of CER to expand beyond drugs and devices to include various delivery models. The health care reform package signed into law in March 2010 includes many of the provisions that the NHC had requested.
- The National Pharmaceutical Council highlighted September's usability symposium in its October newsletter. The article includes interviews with speakers from the event, including NHC CEO Myrl Weinberg (October 30, 2013)
- Dr. D. Daniel Mullins, professor at the University of Maryland School of Pharmacy, delivered the keynote presentation during a National Health Council and National Pharmaceutical Council sponsored symposium on usability and Comparative Effectiveness Research (September 30, 2013)
- NHC CEO Myrl Weinberg talks about working with patients to develop usability criteria for Comparative Effectiveness Research (September 30, 2013)
- National survey shows patients want to be involved in health research (July 11, 2013)
- Delivering Value in Healthcare webinar: NHC Executive Vice President and COO Marc Boutin talks about the need for usability criteria for conducting CER to help patients and other stakeholders make more informed decisions. His presentation begins at 38 min. into the program. (March 28, 2013)
- NHC CEO Myrl Weinberg comments in the American Journal of Pharmacy Benefits on the need for a process to evaluate the usability of research findings (February 1, 2013)
- NHC comments on the Patient-Centered Outcomes Research Institute’s (PCORI) draft Methodology Report (September 14, 2012)
- NHC comments to PCORI on patient perspectives in PCORI's processes (June 18, 2012)
- NHC comments on the PCORI Draft National Priorities for Research and Research Agenda (March 15, 2012)
- NHC comments to the Agency for Healthcare Research and Quality (AHRQ) on engaging stakeholders to prioritize the Effective Health Care (EHC) Program’s future research needs (July 8, 2011)
- NHC commented on the proposed Research Evaluation and Impact Assessment of the American Recovery and Reinvestment Act Comparative Effectiveness Research Portfolio (April 8, 2011)
Comparative effectiveness research (CER) has the potential to improve health outcomes by helping people make better-informed decisions. The National Health Council and Avalere Health have prepared a white paper that outlines the research and discussion to create a framework to guide the development of CER, evaluate its results, and assist in communicating the findings to the right audiences. Follow the discussion on Twitter at #useCER.
Each year, 7 out of 10 deaths in the U.S. are due to chronic diseases. Heart disease, cancer, and stroke account for more than half of all deaths each year. According to the New England Journal of Medicine, people with chronic conditions receive 56% of recommended preventive health services. Improving the quality and delivery of health just care will improve the quality of life for the more than 133 million people with chronic diseases and disabilities in this country.
To provide true value in health care, there must be a confluence of health research and personal circumstances, which include the patient's genetic, ethnic, religious, and social-economic status at the point of care. The marriage of health research with real-world application leads to improved health outcomes and helps us to curb costs responsibly. The NHC has developed a diagram that addresses the elements for getting the Right Care, at the Right Time, for the Right Patient, at the Right Price and has sent the comments to Congress and the Administration:
- National Health Council CEO Myrl Weinberg spoke at a 2013 Capitol Hill briefing in Washington, DC on how to create a value-based health care delivery system that meets the needs of people with chronic diseases and disabilities.
- Letter in support of the Department of Health and Human Services’ (HHS) efforts to address and improve the care of individuals with multiple chronic conditions (July 18, 2010)
- Letter to support full funding in the FY 2011 Labor/HHS/Education Appropriations bill for respite and other critical support programs that provide the safety net for family caregivers. (May 10, 2010)
- NHC letter and draft legislative language to the Senate Finance Committee on a proposed Patient-Centered Care Model. A similar letter was sent to the House Committee on Energy and Commerce. (July 30, 2009)
To learn more about the NHC’s priority policy areas, please select one of the following issue areas: