ADVOCACY
MARCI NEILSON, PHD, MPH
CEO, PATIENT-CENTERED PRIMARY CARE COLLABORATIVE
2:30 PM
Evolution of the PCPCC,
the Patient-Centered Medical
Home, and Advocacy
The Four Camps of Leadership in
Health Care Policy
Greater
Resiliency
Lower
Lower
Understanding
Greater
ABOUT PCPCC – OR “THE
Our Mission
COLLABORATIVE”
 Dedicated to advancing an effective and efficient health system built on a
strong foundation of primary care and the patient-centered medical home.
Activities
 Strengthening public policy that advances and builds support for primary
care and the medical home
 Disseminate results and outcomes from medical home initiatives and
their impact on outcomes, quality and costs
 Convene health care experts and patients to promote learning, awareness,
and innovation of primary care and the medical home
HISTORY OF PCPCC
National not-for-profit coalition founded in 2006 to:
 Facilitate achievements toward the Triple Aim: better
health, better care experience, and health care cost
control
 Create a more effective and efficient model of
healthcare delivery, grounded in primary care
Acts as conveners to bring together thought leaders
and stakeholders to address challenges, opportunities,
and barriers to health system transformation
 Contributed to developing PCMH language for health
reform proposals
 Published dozens of reports
MEMBERSHIP
Since 2006, PCPCC membership has grown to represent
more than 1,000 organizations providing care to 50 million
Americans, including:
 Provider associations
 Large employers
 Health plans
 Providers & health systems
 Pharmaceutical firms
 Policymakers
 Patient advocacy groups
PCPCC RESOURCES
ROLE OF THE COLLABORATIVE
 Challenge the status quo and drive the marketplace
 Disseminate timely information and evidence
 Provide networking & educational opportunities
PCPCC Org Chart
Operations
Committee
Board of Directors
Finance
Committee
Executive
Committee
Employer &
Purchaser
Engagement
Center
Care Delivery
and
Integration
Center
Taskforces
Patient, Family
& Consumer
Center
Special
Interest
Groups
Advocacy &
Public Policy
Center
Event Planning
(Annual Mtgs)
9
Outcomes &
Evaluation
Center
Publications
STATE AND FEDERAL PUBLIC
POLICY
PATIENT = CONSUMER = VOTER
IOM (2002); modified from Dahlgren and Whitehead (1991)
LONGEST MODEL OF PUBLIC
POLICYMAKING
Preferences of individuals, organizations, and interest groups, along with biological, cultural,
Demographic, ecological, economic, ethical, legal, psychological, social and technical inputs
Policy Formulation Phase
Policy Implementation Phase
Agenda Setting
•Problems
•Possible
Solutions
•Political
Circumstances
Development
Formal
of
Enactment
Legislation
Of
Legislation
Rulemaking
Operation
Window of opportunity
Policy Modification Phase
Feedback from individual, organizations, and interest groups experiencing
the consequences of policies, combined with the assessments of the
performance and impact of policies by those who formulate and implement
them, influences future policy formulation and implementation
P
o
l
i
c
y
ADVOCACY AND PUBLIC
POLICY CENTER
Activities & Priorities
The Advocacy & Public Policy Center is dedicated to
working closely with policymakers, agencies and
government leaders at the state and federal levels to
drive health system reform that incorporates key
features of the medical home. The Center shapes
PCPCC’s policy and advocacy agenda and works with
health care stakeholders to support meaningful
policies related to Accountable Care Organizations,
health insurance exchanges, health information
technology, and payment reform.
CENTER ACTIVITIES
 Develop communication tools that enhance public awareness
for primary care, the medical home and key advocacy issues
 Advocate for the development of public policies that strengthen
primary care and the medical home
 Educate state and federal policymakers about the cost-saving and
care delivery impact of primary care and the medical home
 Gather and disseminate evidence that demonstrates medical
home impact on Triple Aim goals
 Work collaboratively with other centers to develop a strategic
public policy agenda
LEADERSHIP OF CABINET
Co-Chairs :
 Shari M. Erickson, MPH
 Vice President, Governmental and Regulatory Affairs, American
College of Physicians
 Greg Pawlson, MD, MPH, FACP
 Senior Medical Analyst, Stevens & Lee
CABINET MEMBERS(1)
 State Government Affairs Analyst, American Academy of Pediatrics
 Director, Federal Affairs, National Committee for Quality Assurance
 Senior Policy Advisor, American Psychological Association
 Vice President, Clinical Programs and Behavioral Health, Amerigroup/WellPoint
 Associate Director, Federal Affairs, American Academy of Pediatrics
 Director, Policy & Government Relations, Kaiser Permanente
 Senior Associate, Legislative Affairs, American College of Physicians
 Executive Director, Alliance for Home Health Quality and Innovation
 Vice President, Advocacy and Practice Advancement, American Academy of Family
Physicians
 Senior Manager, Marketing and Healthcare Policy, Lumeris
 Associate Director, Government Affairs, American College of Clinical Pharmacy
 Director, Federal Affairs, American Congress of Obstetricians and Gynecologists
 Director, Center for Health Policy Research and Ethics, George Mason University
CABINET MEMBERS (2)
 Professor of Public Policy, Departments of Psychiatry and Public Health,
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Family Medicine, Oregon Health and Science University
Director, Government Relations, American Osteopathic Association
Vice President, Nursing Services and Excellence, InnovAge
Senior Advisor, Center for Value-Based Insurance Design, University of
Michigan
Program Director, National Academy of State Health Policy (NASHP)
Director of Health Policy/Federal Government & Professional Affairs,
American Academy of Nurse Practitioners
Senior Policy and Government Affairs Analyst, American Academy of
Pediatrics
Director of Health Partnerships and Policy,YMCA of the USA
Director, Regional Alliances and State Government Affairs Analyst, Sanofi
President and Chief Executive Officer, National Coalition on Health Care
Senior Director, Policy and Strategic Advocacy, Sanofi
Head of Public Policy, Thermo Fisher Scientific
Executive Director, American Psychological Association
ROLE OF THE COLLABORATIVE
(PCPCC)
 Lead from the front
 Challenge the status
quo
 Drive the marketplace
 Disseminate timely
information
 Provide networking &
educational
opportunities
ADVOCACY STATEMENTS
 11/12/2013 -- PCPCC Responds to Latest SGR Proposal from Senate
Finance and House Ways & Means
 09/30/2013 -- Mental Health and Primary Care Integration - PCPCC
Letter to Senate Finance Committee
 08/01/2013 -- PCPCC Extends Support for Bipartisan House 'Doc Fix'
Bill (Press Release)
 07/22/2013 -- PCPCC Supports Draft Legislation to Repeal SGR and
Reform Medicare Physician Payment (Press Release)
 07/18/2013 -- PCPCC Statement to Senate Finance Committee in
Support of Health Care Payment Reform (Press Release)
 12/03/2012 -- PCPCC Leadership Responds to Latest Medical Home
"Systematic Review"
 04/11/2012 -- PCPCC commends federal Comprehensive Primary
Care Initiative: Effort will bring payers and providers together to
advance patient-centered primary care
ADVOCACY/EDUCATION EFFORTS
 Legislative branch
 Need for evidence that the PCMH works
 briefings, letters, visits, materials
 Need for technical assistance on features of the PCMH
 Payment reform (SGR fix), behavioral health integration,
recognition/certification programs
 Tools for legislators/stakeholders to describe PCMH
 Executive branch
 Tracking and highlighting CMMI pilots
 FEHBP, Medicare, Medicaid, Military
 Publicizing success stories – case studies, webinars, meetings
Q AND A
 What are the PCPCC lessons learned that translate to
Colorado?
 Buy-in
 Transparency
 No surprises
 Which constituencies are missing from your collaborative
that can help you advocate effectively?
 How will you decide on your priorities and not suffer from
mission creep?
Contact:
Marci Nielsen, PhD, MPH
Chief Executive Officer
mnielsen@pcpcc.net
www.pcpcc.net