Since the passage of the Patient Protection and Affordable Care Act (ACA), the National Health Council (NHC) has identified the following priority areas on which to focus
In response to the Department of Health and Human Services’ proposed rule on redetermining the eligibility of participants in the health insurance exchanges, the National Health Council submitted comments to Secretary Sylvia Burwell.
“We believe it is vital that HHS ensure that transparency is paramount when working with exchange enrollees during the redetermination and eligibility process,” the letter reads. “It is critical that patients have a clear understanding of any and all changes affecting their health coverage, and that these changes are stated in a clear, concise, and transparent manner. People with chronic conditions, as potentially high users of health care services, are the patient population most at risk of adverse outcomes resulting from poor enrollment choices.”
The letter presents two specific recommendations and the reasoning behind them:
- For individuals subject to enrollment in a new plan or product in 2015 due to their 2014 plan or product being unavailable, assignment to a plan with similar premium and metal level should take priority over assignment to a plan under the same carrier.
- The federal government should streamline the redetermination and notification processes for individuals and families with limited income who are eligible for assistance with premiums and/or cost sharing in the exchange.
To view the letter, please click here.
On January 23, 2014 the National Health Council (NHC) launched PuttingPatientsFirst.net, a new website with an interactive set of tools designed to help people learn about their health insurance options. The site includes resources on health insurance and marketplaces, a health care cost estimator, and a place for visitors to share their health care experiences. Visit PuttingPatientsFirst.net to learn more.
The NHC also 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.
Other ACA Resources:
- NHC comments on the proposed rule on exchange and insurance market standards for 2015 and beyond (April 21, 2014)
- NHC comments on a HHS draft letter on the need for increased network adequacy standards and patient protections against discriminatory plan designs (February 25, 2014)
- 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 (August 21, 2013)
- 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 urges HHS to provide clarity on whether cost-sharing assistance programs will be permitted for members of marketplace plans (December 4, 2013)
- 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)
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. CER has the potential to improve health outcomes by helping people make better-informed decisions. The National Health Council and Avalere Health 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.
- 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)
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 commented on a proposed rule by the Centers for Medicare and Medicaid Services concerning the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (March 7, 2014)
- 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.
To learn more about the NHC’s priority policy areas, please select one of the following issue areas:
Click here to read archived NHC letters of support and position statements.