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D Agenda The Impact of the Affordable Care Act on U.S. Preparedness Resources and Programs: An Institute of Medicine Workshop November 18-19, 2013 Lecture Room of the National Academy of Sciences Building 2101 Constitution Avenue, NW, Washington, DC 20418 Background: With many elements of the Affordable Care Act (ACA) going into effect in 2014, and the establishment of many new rules and regulations, there have been and will continue to be significant changes to the U.S. health system. However, it is not clear what impact these changes will have on medical and public health preparedness programs around the country. As funding for these programs continues to decline, leveraging changes in health care delivery and structure to enhance and increase individual and community preparedness becomes even more important. This workshop will examine how the changes to the health system as a result of the ACA may impact the medical and public health prepared- ness programs across the nation, and how the ACA provisions may be leveraged to strengthen the resilience of the medical and public health preparedness systems. Beginning with discussions on changing financing and delivery, and moving to more detailed conversations on roles and potential within threat identification and information technology infra- structure, participants will examine current and future opportunities for 107
108 IMPACTS OF THE ACA ON PREPAREDNESS protecting the nationâs health in disasters through new relationships and more integrated care. Meeting Objectives: ⢠Explore opportunities to leverage benefits of health care reform and develop action steps that the preparedness community can take to mitigate identified challenges. ⢠Discuss challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country. ⢠Consider how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities. ⢠Explore potential impacts that the changing health care delivery infrastructure may have on disaster preparedness and response. ⢠Consider how impacts on the health system workforce may im- pact resilience, emergency preparedness, response, mitigation, and recovery. ⢠Explore how changes to data collected through health infor- mation technology may be used to strengthen community resilience. ⢠Evaluate needs and opportunities in data collection, surveillance, and communication for robust threat identification and public health response. November 18, 2013 8:30 a.m. Welcome and Introductions GEORGES BENJAMIN, Workshop Co-Chair Executive Director American Public Health Association GREGG MARGOLIS, Workshop Co-Chair Director Division of Health Systems and Health Care Policy Office of the Assistant Secretary for Preparedness and Response 8:40 a.m. Keynote: Challenges and Opportunities for Public Health and Health Care Preparedness
APPENDIX D 109 NICOLE LURIE Assistant Secretary for Preparedness and Response Department of Health and Human Services SESSION I: Overview of the Affordable Care Act Provisions and Financing Changes Session Objectives: ⢠Discuss changes taking place within health care delivery reform and possible implications on preparedness. ⢠Explore a case study of Massachusetts health reform and its im- pact on preparedness and response. ⢠Consider how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities. 9:10 a.m. How the Health Delivery System Will Be Changing and Lessons Learned in Massachusetts Since 2006 BRUCE RUEBEN President Florida Hospital Association LISA TOFIL, Planning Committee Partner Holland & Knight S. ATYIA MARTIN Director, Office of Public Health Preparedness Boston Public Health Commission 10:10 a.m. Discussion with Attendees 10:40 a.m. BREAK 11:00 a.m. Opportunities and Challenges Within Financing Changes JACK EBELER, Planning Committee Principal Health Policy Alternatives
110 IMPACTS OF THE ACA ON PREPAREDNESS KAREN DESALVO Health Commissioner City of New Orleans 11:40 a.m. Discussion with Attendees 12:00 p.m. LUNCH SESSION II: Impacts of Changes in Health Care Workforce and Delivery Session Objectives: ⢠Explore potential impacts that changing health care delivery in- frastructure may have on disaster preparedness and response. o Discuss community health models and systems integration to augment population health care. ⢠Consider how impacts on the health system workforce may im- pact resilience, emergency preparedness, response, mitigation, and recovery. 1:00 p.m. Session Chair: Introduction and Overview of Objectives CHARLES CAIRNS Chair of Emergency Medicine University of North CarolinaâChapel Hill Principal Investigator of the National Collaborative for Bio- Preparedness 1:15 p.m. Panel Discussion: Impacts of Changing Physical and Social Infrastructure XIAOYI HUANG Assistant Vice President for Policy Americaâs Essential Hospitals NORMAN MILLER Trauma System Administrator Mississippi State Department of Health
APPENDIX D 111 MATT ZAVADSKY, Planning Committee MedStar Mobile Community Health Program 2:15 p.m. Discussion with Attendees 2:45 p.m. BREAK 3:05 p.m. Panel Discussion: New Expectations and Capabilities of Preparedness Workforce ELLEN EMBREY Managing Partner, Stratitia Former Deputy Assistant Secretary of Defense Force Health Protection & Readiness Department of Defense ANI TURNER Deputy Director Center for Sustainable Health Spending Altarum Institute âView from the groundâ CHAD PRIEST MESH Coalition Indianapolis, IN 4:00 p.m. Discussion with Attendees 4:30 p.m. ADJOURN November 19, 2013 8:30 a.m. Welcome and Introduction GEORGES BENJAMIN, Workshop Co-Chair Executive Director American Public Health Association
112 IMPACTS OF THE ACA ON PREPAREDNESS GREGG MARGOLIS, Workshop Co-Chair Director, Division of Health Systems and Health Care Policy Office of the Assistant Secretary for Preparedness and Response SESSION III: Information Infrastructure Session Objectives: ⢠Explore how changes to data collected through health information technology may be used to strengthen community resilience. o Discuss corresponding benefits and barriers to greater access to patient and population data in disasters. 8:40 a.m. Session Chair: Introduction and Overview of Objectives KEVIN LARSEN Medical Director of Meaningful Use Office of the National Coordinator for Health Information Technology Department of Health and Human Services 8:50 a.m. Panel Discussion: Opportunities for Enhanced Resilience Through Technology: Aggregate and Individual Patient Focus ROLAND GAMACHE Director, Public Health Informatics National Association of County and City Health Officials JUSTIN BARNES Vice President Greenway Medical Technologies Board Member, CommonWell Health Alliance JAMES MARCIN Director, Pediatric Telemedicine Program University of California, Davis
APPENDIX D 113 âView from the groundâ CONNIE CHAN Project Director, PCCI Dallas, TX 9:50 a.m. Discussion with Attendees 10:15 a.m. BREAK SESSION IV: Needs and Opportunities for Threat Identification and Public Health Response Session Objectives: ⢠Evaluate needs and opportunities in data collection, surveillance, and communication for robust threat identification and public health response. o Discuss roles for public health in mass vaccinations or routine immunization provision. 10:30 a.m. Session Chair: Introduction and Overview of Objectives GEORGES BENJAMIN, Workshop Co-Chair Executive Director American Public Health Association 10:40 a.m. Panel Discussion: Data Collection, Surveillance, and Communication: Potential for Enhancing Threat Identification GARRETT DAWKINS Director, Transitions of Care and Public Health Surescripts, LLC GUS BIRKHEAD Deputy Commissioner and Director of Public Health Programs New York State Department of Health
114 IMPACTS OF THE ACA ON PREPAREDNESS CHARLES CAIRNS Chair of Emergency Medicine University of North CarolinaâChapel Hill Principal Investigator of the National Collaborative for Bio-Preparedness âView from the groundâ ANDREW SCHROEDER Director of Research and Analysis Direct Relief 11:40 a.m. Discussion with Attendees 12:10 p.m. LUNCH 1:10 p.m. Panel Discussion: Continuing Roles for Public Health Response: Mass Immunization/Medical Countermeasure Delivery and PublicâPrivate Partnership NATHANIEL HUPERT Associate Professor of Public Health and Medicine Weill Cornell Medical College BRANDON DEAN Staff Analyst Los Angeles County Department of Public Health âView from the groundâ MICHELLE MCGUIRE Senior Project Manager Kansas Health Information Network 2:10 p.m. Discussion with Membership 2:35 p.m. BREAK
APPENDIX D 115 SESSION V: âViews from the Groundâ Session Objectives: ⢠Explore opportunities to leverage benefits of health care reform and action steps the preparedness community can take to miti- gate identified challenges. o Review perspectives of âon the groundâ panelists and top areas for the preparedness community to capitalize on moving forward. 2:50 p.m. Session Chair: Introduction and Overview of Objectives TERRY ADIRIM, Planning Committee Special Consultant, Maternal and Child Health Health Resources and Services Administration Department of Health and Human Services 3:00 p.m. Response Panel: Views from the Ground across Focus Areas KAREN DESALVO Health Commissioner City of New Orleans CONNIE CHAN Project Director, PCCI Dallas, TX ANDREW SCHROEDER Director of Research and Analysis Direct Relief MICHELLE MCGUIRE Senior Project Manager Kansas Health Information Network (KHIN) 4:00 p.m. Discussion with Attendees 4:20 p.m. Next Steps: Key Takeaway Messages ⢠What issues have not been addressed?
116 IMPACTS OF THE ACA ON PREPAREDNESS ⢠How can people engage their communities to pass on lessons learned? 4:45 p.m. ADJOURN