Affordable Care Act Implementation

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Affordable Care Act Implementation 

Implementation of the Patient Protection and Affordable Care Act of 2010

General Resources

  • Resource: Multiple Chronic Conditions: A Strategic Framework - U.S. Department of Health and Human Services, December 2010 - The intention for this framework is to catalyze change within the context of how chronic illnesses are addressed in the United States - from an approach focused on individual chronic diseases to one that uses a multiple chronic conditions approach.

Legislation

Public Law 111-148

The following are provisions that are of particular interest to academic pharmacy in that their implementation can be directly impacted by some aspect of a faculty member's teaching, research or service expectations. The document will be regularly updated to provide information about implementation. The document will also include resources to support AACP member participation in implementing the provision. While every effort will be made to keep the document current, AACP members are encouraged to access www.healthcare.gov for the most up-to-date information. Faculty interested in pursuing grant funding should sign up for regular e-mail updates from www.grants.gov.

For convenience, the provisions are listed in numeric order. Sections 2703-3508 include the quality improvement through primary care coordination-related issues such as medical homes and accountable care organizations. Sections 4002- 4305 include the prevention and wellness provisions. Sections 5001- 5405 included the health professions workforce provisions. Please note the following:

The most recent implementation activity will be marked with an asterisk (*) and italicized.

Resource documents will be bulleted.

Section 2701 - The Secretary shall identify and publish a recommended core set of adult health quality measures for Medicaid eligible adults.

On Dec. 30, 2010 the Centers for Medicare and Medicaid Services (CMS) published a notice with comment period of Medicaid “Initial core set of health quality measures for Medicaid-eligible adults.” The request for comments was published in the Dec. 30 edition of the Federal Register.

Many of the quality measures would appear to include/require attention to medication management. In a conversation with staff at the Pharmacy Quality Alliance (PQA), it is clear that this core set of quality measures was highly impacted through PQA work.

Section 2703 - Beginning Jan. 1, 2011, State Medicaid programs can elect to change their state plans to allow teams of providers to establish health homes to care for individuals with chronic illness. Health homes will be responsible for coordinating care across the care continuum, tracking hospital readmissions and patient adherence to care plans. A health team can include a pharmacist.

The Joint Commission will develop medical home requirements for inclusion in its accreditation process for ambulatory care. The requirements are aligned with those developed by the Agency for Healthcare Research and Quality and can be found online.

For those of you wondering how to best position yourself and the profession of pharmacy for successful integration into the patient-centered medical home (or health home) look to the Agency for Healthcare Research and Quality (AHRQ). The evidence-based resources are focused on providers and patients, written in plain language and provide important information for making the case for the pharmacist role in the medical home. Not sure what the medical home refers to? The Center for Primary Care, Prevention and Clinical Partnerships provides resources on the AHRQ Web site. Already integrated and need additional evidence to support your ongoing participation? The Center for Effective Healthcare evidence reports provide evidence of healthcare quality improvements through collaboration, which can also be found on the AHRQ Web site. Reports and information is added regularly to these sites. Keep abreast of the latest information by signing up for listservs on either the above referenced Web pages.

Section 2704 - Beginning Jan. 1, 2012, the Secretary shall initiate a demonstration project to evaluate integrated care around a hospitalization for Medicaid patients. This demonstration creates a bundled payment for an episode of care and must include a robust discharge planning process.

Section 2705 - Beginning FY11, the Secretary shall initiate a demonstration project that will move safety-net hospitals from fee-for-service to a global capitated payment.

Section 2706 - Beginning Jan. 1, 2012, the Secretary shall implement a demonstration project that will allow the creation of accountable care organizations (ACO) for the care of pediatric patients. Any cost savings above a certain threshold will be shared with the ACO.

Section 2707 - Beginning Oct. 1, 2011, there will be appropriations available for the Secretary to establish an emergency psychiatric stabilization demonstration project for certain Medicaid individuals. Projects will focus on the stabilization, discharge planning and care management of certain patients.

Section 3001 - Beginning Oct. 1, 2012, the Secretary shall establish a hospital value-based purchasing program, which will offer eligible hospitals (including inpatient critical access hospitals) incentive payments for meeting performance standards for services delivered to certain Medicare patients.

On April 9, 2012, CMS released the 125 quality measures that clinicians and healthcare institutions eligible to participate in the meaningful use program can select from to participate in the bonus payment incentives. Eligible clinicians must select 12 of the 125. Institutions must select 24 of the 125. Meeting the selected quality measures, through the interventions including the meaningful use of health information technology as described in the recently released notice of proposed rule making regarding stage 2 of meaningful use, will allow clinicians and institutions to receive an incentive payment. Many of the quality measures are associated with medication management creating a significant opportunity for pharmacists to be a valued patient-centered, team-based approach to care promoted through meaningful use and the broader intent of the Affordable Care Act.

On Jan. 13, 2011, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for the establishment of a Medicare valued-based purchasing program for inpatient hospitals. Comments on the proposed rule will be accepted until March 8, 2011.

Most of the 45 proposed quality measures are NQF consensus-based measures currently being used by Medicare inpatient hospitals. Twenty-seven process measures come from patient–chart reviews. Fifteen are claims-based measures. Three are structural measures. These measures are outlined in the Federal Register notice and more information about them is available on the CMS quality Web site. Most of the measures currently are part of the CMS Hospital Compare quality comparison Web page.

Section 3011 - By Jan. 1, 2011, the Secretary shall submit a national strategy to improve the delivery of health care services, patient health outcomes and population health.

Section 3012 - The Secretary will be assisted in the development of a national healthcare quality strategy by a President-appointed interagency working group.

On March 22, 2011 the Department of Health and Human Services released the final version, reflecting comments received on the draft strategy in October, of the National Strategy for Quality Improvement in Health Care. The strategy continues the focus of reorganizing our health system around the quality principles of improving the patient experience, addressing care across populations and controlling costs.

The Secretary of HHS published a request for comments on a proposed National Health Care Quality Strategy on Sept. 9, 2010. Comments were accepted until Oct. 15, 2010.

  1. Resource: Pharmacy-related quality measure development and testing are undertaken by the Pharmacy Quality Alliance.

Section 3013 - Beginning FY11, there are appropriations available for the Secretary, consulting with the AHRQ Director, to identify quality measure gaps and existing measures that need improvement and to award grants to eligible entities to address these actions.

  • Resource: Keep abreast of all federal grant opportunities including those offered through the Agency for Healthcare Research and Quality (AHRQ) by signing up for updates at www.grants.gov.

Section 3021 - No later than Jan. 1, 2011, the Secretary shall establish the Center for Medicare and Medicaid Innovation (CMMI), the purpose of which is to test innovative payment and service delivery models that may lead to reduced program expenditures while maintaining or improving quality. Models include patient-centered medical homes, healthcare innovations zones, care-coordination through HIT support interdisciplinary teams including those focused on transitions of care and medication therapy management, and those that move away from fee-for-service to salary-based or comprehensive risk-based or salary-based payments.

*On Friday, June 15, 2012, the Center for Medicare and Medicaid Innovation Health Care Innovation Challenge announced the recipients of second round winners. This second round of challenge awardees clearly articulates CMMI’s recognition of the value of integrating the pharmacist into innovative care models all aimed at improving health, improving healthcare and constraining costs. Award recipients will implement their successful proposals over the next three years. The results of these innovations will provide the Secretary of HHS the necessary evidence to determine how to best reorganize the Medicare, Medicaid and S-CHIP programs for future sustainability and effectiveness.

On April 11, 2012, Center for Medicare and Medicaid Innovation (CMMI) announced that seven geographic areas were selected to participate in the comprehensive primary care initiative. This innovative approach to improving health, improving healthcare and constraining costs employs a multi-payer approach to strengthen the primary care services within that geographic area. After each payer signs a memorandum of understanding with the Centers for Medicare and Medicaid Services (CMS) up to 75 primary care practices within the specific geographic area will be allowed to enroll in the multi-payer program. Providers will receive an additional care-coordination fee that is seen as providing an incentive to improve care quality.

On Friday, April 15, 2011 the CMS Innovation Center announced grants to 15 states for integrating care for Medicaid/Medicare dual eligible individuals. This would appear to be an important opportunity for your faculty to reach out to your state Medicaid program and/or governor’s office to discuss how to improve care through the integration of pharmacist services (including MTM) across the continuum of care for dual eligibles. This is a planning grant and not an implementation grant. The funds will support states in the development of potential approaches that will then be reviewed and analyzed by CMS for their potential benefit and possible implementation in the future.

  • Resource: The CMS description of the state demonstration grants is available here.

  • Resource: CMS Federal Coordinated Health Care Office (Duals Office) Web site.

The CMMI updated its Web site. Interested parties may submit innovative practice and payment models via this Web site.

During the 2011 AACP Interim Meeting, Anthony D. Rodgers, deputy administrator of the Centers for Medicare and Medicaid Services, presented information about CMS implementation of many of the ACA provisions including the Center for Medicare and Medicaid Innovation.

For those of you wondering how to best position yourself and the profession of pharmacy for successful integration into the patient-centered medical home (or health home) look to the Agency for Healthcare Research and Quality (AHRQ). The evidence-based resources are focused on providers and patients, written in plain language and provide important information for making the case for the pharmacist role in the medical home. Not sure what the medical home refers to? The Center for Primary Care, Prevention and Clinical Partnerships provides resources on the AHRQ Web site. Already integrated and need additional evidence to support your ongoing participation? The Center for Effective Healthcare evidence reports provide evidence of healthcare quality improvements through collaboration, which can also be found on the AHRQ Web site. Reports and information is added regularly to these sites. Keep abreast of the latest information by signing up for listservs on either the above referenced Web pages.

As authorized as a Medicare program quality improvement strategy in the Affordable Care Act (Section 3021 of PL 111-148) the Centers for Medicare and Medicaid Services (CMS) introduced the Center for Medicare and Medicaid Services on Tuesday, Nov. 16, 2010. As stated in the legislation the purpose of the Center is to “test innovative payment and service delivery models that may lead to reduced program expenditures while maintaining or improving quality.” Models include patient-centered medical homes, healthcare innovations zones, care-coordination through HIT support interdisciplinary teams including those focused on transitions of care and medication therapy management and those that move away from fee-for-service to salary-based or comprehensive risk-based or salary-based payments.

The Center has announced several new initiatives including a multi-payer primary care practice demonstration that will take place in Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota.

On Sept. 30, 2010, the Centers for Medicaid and Medicare Services announced that Robert Gilfillan, former President and CEO of Geisinger Health Care system in Danville, Pa., will be named the acting Director of the Center for Medicare and Medicaid Innovation.

Section 3022 - No later than Jan. 1, 2012, the Secretary shall establish a shared savings program that will allow Medicare fee-for-service beneficiaries to receive their care through an accountable care organization that will be responsible for their care management and coordination.

On April 9, 2012, CMS released the inaugural group of participants in shared-savings program. Twenty-seven organizations have aligned to participate in the program as accountable care programs.

The Centers for Medicare and Medicaid Services published a proposed rule for implementing the Medicare Accountable Care Organizations. The proposed rule limits participation to certain providers and entities eligible to participate in Medicare Part A and Part B. CMS seeks public comment prior to June 6, 2011.

Section 3023 - No later than Jan. 1, 2013, the Secretary shall establish a pilot program for integrated care during an episode of care provided to certain Medicare beneficiaries around a hospitalization in order to improve the coordination, quality and efficiency of healthcare services.

Section 3024 - No later than Jan. 1, 2012, the Secretary shall establish a demonstration to test a payment incentive and service delivery model that utilizes physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improve health outcomes in the provision of items and services to certain Medicare beneficiaries. The teams could include a pharmacist.

On Wednesday, Sept. 28, 2011 the Centers for Medicare and Medicaid Services announced the release of a request for proposals that would establish a shared-savings payment approach for the delivery of coordinated, comprehensive primary care services.

  • Resource: CMS has created a Web page that describes the “Comprehensive Primary Care Initiative.”

Section 3025 - Beginning Oct. 1, 2012, the Secretary shall establish a hospital readmissions reduction program that will reduce payments to certain hospitals with readmission rates for certain Medicare patients.

Section 3026 - Beginning Jan. 1, 2011, the Secretary shall establish a program of five-year’s duration that will establish community-based care transitions programs focused on improving care transition services (including conducting comprehensive medication review and management) for certain Medicare beneficiaries.

On Nov. 18, 2011, the Centers for Medicare and Medicaid Services (CMS) have released the recipients of the first round of the Community Based Care Transitions Program grants, part of the Partnership for Patients initiative. Community-based organizations can continue to submit proposals to the CMS Innovation Center as funding will be available at least through June 2012.

The Centers for Medicare and Medicaid Services (CMS) published a request for proposals in the April 15 edition of the Federal Register for the Community-based transitions program. Community-based organizations (CBO) will partner with hospitals experiencing high readmission rates for high-risk Medicare beneficiaries. The program is authorized in Section 3026 of the Affordable Care Act (PL 111-148). Colleges and schools of pharmacy are not specifically included in the definition included in Section 3026 or the list of eligible community-based organizations in the published RFP, but faculty are encouraged to partner with eligible CBOs, which include Area Agencies on Aging among others. The partnership leverage point is the fact that a high percentage of readmissions are the result of poor medication management including medication reconciliation at discharge. Faculty at colleges and schools of pharmacy are already involved with hospitals and health systems in the area medication reconciliation. These activities provide an evidence-base sufficient to encourage an eligible CBO to include you as a partner in their proposal submission.

  • Resource: Federal Register notice

Section 3501 - By Oct. 1, 2011, the Director of the Agency for Healthcare Research and Quality shall establish the Center for Quality Improvement and Safety, which will support the Director to “identify, develop, evaluate, disseminate, and provide training in innovative methodologies and strategies for quality improvement practices in the delivery of health care services that represent best practices (referred to as 'best practices') in health care quality, safety, and value .”

Section 3502 - The Secretary shall establish a program for awarding grants to eligible entities for the creation of community-based health teams that will support primary care practices including ob/gyn practices. The community-based health teams may include pharmacists.

Section 3503 - No later than May 1, 2011, the Secretary, working through the Center for Quality Improvement and Safety, shall establish a program to provide grants to eligible entities to implement medication management services provided by licensed pharmacists, as a part of a collaborative, interdisciplinary, interprofessional approach to the treatment of chronic diseases for targeted individuals, to improve the quality of care and reduce overall cost in the treatment of such diseases.

Working collaboratively during 2011, a group of pharmacy organizations, including AACP, developed a list of research questions regarding MTM. These questions were forwarded to the Pharmacy Quality Alliance and then submitted to AHRQ’s Effective Healthcare Program. AHRQ prepared a document indicating that the MTM questions would be approached through a systematic review of the evidence. The AHRQ nomination summary document prepared for this item states: “A conceptual framework that represents the breadth and context of MTM services, a synthesis of what is currently known about the comparative effectiveness of MTM programs and program components, and a delineation of the gaps in the existing evidence base are needed at this time. Therefore, this topic will move forward for a new comparative effectiveness review.” To date, due to funding restrictions, AHRQ has not pursued the systematic review.

  1. Resource: Patient Centered Primary Care Collaborative MTM document - "Integrating Comprehensive Medication Management to Optimize Patient Outcomes"
  2. Resource: Improve patient safety in federally-qualified health centers through participation in the Health Resources and Services Administration’s Patient Safety and Clinical Pharmacist Collaborative

Section 3508 - The Secretary may award grants to eligible entities (including schools of pharmacy) to develop curricula that integrate the concepts of quality improvement and patient safety into the clinical education of health professionals.

Section 4001 - By July 1, 2010, the National Prevention, Health Promotion and Public Health Council, a federal interagency group established by the President, shall make its first annual report which will continue through January 2015. The Council will be supported by a 25-member, President-appointed Advisory Group on Prevention, Health Promotion and Integrative Public Health. The Council will serve as a coordinating body for federal health promotion and wellness efforts; make recommendations, based on stakeholder input, for a national health promotion and wellness strategy; and make recommendations to the President for federal health promotion and wellness priorities.

The Council released its 2010 report on July 1.

On June 16th the U.S. Surgeon General, Chair of the National Prevention, Health Promotion and Public Health Council, released the National Prevention Strategy. The final version of the Strategy takes into public comments received since the publication of the draft strategy in July 2010.

The Council seeks public comments on the strategy presented within its 2010 report and expects to publish a final strategy document by March 2011.

  1. Resource: National Prevention, Health Promotion and Public Health Council 2010 Annual Status Report

Section 4002 - Beginning in FY10, the Secretary “shall transfer amounts in the Fund to accounts within the Department of Health and Human Services to increase funding, over the fiscal year 2008 level, for programs authorized by the Public Health Service Act, for prevention, wellness, and public health activities including prevention research and health screenings, such as the Community Transformation grant program, the Education and Outreach Campaign for Preventive Benefits, and immunization programs.” Fund amounts increase annually to $2 billion in FY 2015 and thereafter.

On Sept. 24, 2010 the Centers for Disease Control released $100 million from the Fund in the form of grants for public health and prevention priorities. These priorities include HIV testing, tobacco cessation and improving the public health infrastructure. HHS Press Release

Section 4003 - The current law authorizing the Preventive Services Task Force, supported by the Agency for Healthcare Research and Quality (AHRQ), is amended to more clearly articulate the purpose of the Task Force and the expectations for development and ongoing review of evidence-based clinical preventive services.

This section also authorizes the creation of a new Independent Community Preventive Services Task Force, supported by the Centers for Disease Control and Prevention (CDC). The Task Force will focus on the development and evaluation of population-based prevention programs.

*No dedicated appropriations (Such sums as necessary)

A notice of request for nominations to the United States Preventive Services Task Force was published in the Aug. 20, 2010 edition of the Federal Register.

Nominations to the USPSTF closed on Oct. 1, 2010. AACP nominated two individuals to serve on this Task Force, which is charged with the development of recommendations for preventive services integral to moving our healthcare system from an acute care system to one focused on disease prevention and wellness.

  1. Resource: The list of USPSTF recommended preventive services can be found on the AHRQ Web site.

Section 4004 - By Jan. 1, 2011, the Secretary shall report on the development of an education and outreach campaign regarding preventive benefits. This national media campaign will provide patients and providers with information to better assess their health status and engage in healthy behaviors through information provided by the campaigns communication plan including the development of Web-based resources. The Web-based resources will include assessment tools developed and maintained by academic institutions.

*No dedicated appropriations (Such sums as necessary)

As of Sept. 23, 2010 health plans will cover certain preventive services without the beneficiary having to pay a copayment, coinsurance or charging a deductible. The Affordable Care Act’s New Rules on Preventive Care and You.

Section 4101 - Beginning FY10 through FY13, a new grant program is created to support the development of school-based health centers that shall provide comprehensive primary care services including treatment of chronic illness to school-aged children with parental consent. A center is expected to establish and maintain ongoing relationships with health professionals in the catchment area.

Section 4103 - Beginning Jan. 1, 2011, Medicare will provide payment for a beneficiary’s annual wellness visit that can be provided by a team of providers as described by the Secretary and is to include a list of all a beneficiaries' providers and a list of all their prescribed medications.

  • Resource: The Centers for Medicare and Medicaid web page includes updates on benefits for Medicare beneficiaries. To learn about these, including the annual wellness visit benefit visit this site.

Section 4106 - Beginning Jan. 1, 2013, state Medicaid programs shall include services recommended by the U.S. Preventive Services Task Force and adult immunizations approved by the CDC Advisory Committee on Immunization Practice and “any medical or remedial services (provided in a facility, a home, or other setting) recommended by a physician or other licensed practitioner of the healing arts within the scope of their practice under State law, for the maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level.”

Section 4107 - Beginning Oct. 1, 2010, state Medicaid programs shall cover the provision of comprehensive tobacco cessation services for pregnant women. Medicaid will pay for “counseling and pharmacotherapy for cessation of tobacco use by pregnant women means diagnostic, therapy, and counseling services and pharmacotherapy (including the coverage of prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration) for cessation of tobacco use by pregnant women who use tobacco products or who are being treated for tobacco use that is furnished: by or under the supervision of a physician; or by any other health care professional who is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by state law) of the State in which the services are furnished and is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose.”

Section 4108 - Beginning Jan. 1, 2011, the Secretary shall make available grants to state Medicaid programs for the development, implementation and evaluation of programs developed to increase Medicaid eligible individuals participation in chronic disease prevention programs. These programs shall focus on tobacco cessation, weight reduction and control, lowering blood pressure and cholesterol, avoiding diabetes onset or effective management of diabetes.

Section 4201 - Beginning FY2011, the Secretary, through the CDC, shall make available competitive grants, referred to as Community Transformation Grants, to “State and local governmental agencies and community-based organizations for the implementation, evaluation, and dissemination of evidence-based community preventive health activities in order to reduce chronic disease rates, prevent the development of secondary conditions, address health disparities, and develop a stronger evidence-base of effective prevention programming.”

*On May 29, 2012, the Centers for Disease Control and Prevention (CDC) published the announcement for applications for the Community Transformation Grants Program. The application deadline is July 31, 2012.

The U.S. Department of Health and Human Services announced on May 13, 2011 the implementation of the Community Transformation Grants (CTG) program. The CDC has created a CTG Web site where you can access all the information pertinent to the CTG program.

  1. Resource: For information regarding the Communities Putting Prevention to Work program (funded in part by the American Recovery and Reinvestment Act) at the CDC, visit its Web site.

Section 4202 - Beginning FY11, the Secretary working through the CDC, shall make grants available to state and local health departments and Indian tribes for the creation of community interventions, screenings and referrals to individuals 55-64 years old (pre-Medicare). The Secretary, working through CMS, shall evaluate these programs to ensure that they are evidence-based. The community interventions and screenings including tobacco cessation and chronic-illness self-management and should be in conjunction with insurance companies and community health centers.

Section 4203 - Beginning in 2010, the Secretary shall make available grants to states to increase access to recommended immunizations.

Section 4301 - The Secretary, working through the CDC, shall provide funding for public health services and systems research.

Section 4302 - Two years after implementation (March 2012), federally-supported activity shall capture : A) data on race, ethnicity, sex, primary language and disability status for applicants, recipients, or participants;(B) data at the smallest geographic level such as state, local, or institutional levels if such data can be aggregated; (C) sufficient data to generate statistically reliable estimates by racial, ethnic, sex, primary language and disability status subgroups for applicants, recipients or participants using, if needed, statistical oversamples of these subpopulations; and (D) any other demographic data as deemed appropriate by the Secretary regarding health disparities.

On Thursday June 30, 2011, the Secretary of HHS published a notice in the Federal Register seeking public comment on the proposed data collection standards that meet the intent of Section 4302. The public comment period is open until Aug. 1, 2011. The Federal Register notice is available here.

Section 4303 - The Director of CDC will be responsible for expanding access to health promotion and wellness programs in the workplace by providing information and consultation to employers regarding evidence-based programs to employers. This section also includes a program evaluation requirement.

Section 4305 - Within one year of funding availability, the Secretary shall seek the support of the Institute of Medicine to establish a conference on pain and pain management. This Section requests the NIH to continue its support of pain research. This Section also requires the Secretary to make grants available to entities including health professions schools for the development and implementation of curriculum that include pain management provided in an interdisciplinary approach.

*No dedicated appropriations (Such sums as necessary)

Section 5001 - States the purpose of provisions related to health workforce is to increase access particularly for underserved populations (in all contexts) to healthcare professionals competent to deliver patient-centered care. The provisions lend themselves to this goal by: improving workforce data collection and analysis to determine adequate supply of qualified practitioners; and improving health professions education to ensure patient-centered competencies of graduates and practicing professionals.

Section 5002 - Includes definitions that include amendments to the Area Health Education Centers (AHEC) that defines an organization eligible to be an AHEC as including “universities or colleges not operating a school of medicine or osteopathic medicine.”

Section 5101 - Authorizes the establishment of a National Health Care Workforce Commission that is: advisory to the President; coordinates with the activities of federal agencies involved with health workforce and workforce in general; supports evaluation of health workforce education and demand; identifies and addresses barriers to effective federal, state and local activity related to health workforce; advocates for innovative approaches to continuous improvement in health professions education focused on patient need, technology changes, and other factors.

*No dedicated appropriations (Such sums as necessary)

Commission nominations were announced by the Comptroller General of the Government Accounting Office on Sept. 30, 2010. Dr. Brian Isetts from the University of Minnesota College of Pharmacy was appointed to serve on the Commission. GAO Press Release

Section 5102 - Establishes a competitive grant program to assist states in comprehensive health workforce planning.

*No dedicated appropriations after FY10 (Such sums as necessary)

Awarding of state workforce planning grants was announced by HRSA on Sept. 27, 2010. A total of $5.6 million was awarded to 26 states to support state level health professions workforce planning. HHS Press Release

Section 5103 - Establishes a National Center for Workforce Analysis. The Center will work in coordination with the Commission established in Section 5101. The Center will be supported by state workforce centers, which will be established through grants or contracts. Health professions schools are among the entities eligible to be a state or regional center.

*No dedicated appropriations (Such sums as necessary)

This Center has already been created and Ed Salsberg, well-known workforce researcher and formerly with the Association of American Medical Colleges, will head up the new Center housed in the Health Resources and Services Administration. HRSA Health Professions Web site

Section 5204 - Establishes the Public Health Workforce Loan Repayment Program. An Individual eligibility requirements include: be accepted for enrollment, or be enrolled, as a student in an accredited academic educational institution in a state or territory in the final year of a course of study or program leading to a public health or health professions degree or certificate; and have accepted employment with a federal, state, local, or tribal public health agency, or a related training fellowship, as recognized by the Secretary, to commence upon graduation; have graduated, during the preceding 10-year period, from an accredited educational institution in a state or territory and received a public health or health professions degree or certificate; and be employed by, or have accepted employment with, a federal, state, local, or tribal public health agency or a related training fellowship, as recognized by the Secretary.

Section 5209 - Eliminates the current cap of 2,800 members of the commissioned corps.

Section 5210 - Establishes a Ready Reserve Corps within the Public Health Services commissioned corps for deployment during national emergencies at the call of the Surgeon General.

Section 5303 - The primary care training grants program is amended to include: a grant priority to applicants that: propose innovative approaches to education including “team management of chronic disease, interprofessional integrated models of care that incorporate transitions of care…; teaches skills related to interprofessional, integrated care through collaboration with other health professionals…”

15 percent of funding for the primary care training grants shall go to physician assistant programs.

*No dedicated appropriations after FY10 (Such sums as necessary)

On Sept. 17, 2010 HHS awarded more than $130 million to increase primary care workforce and the diversity of the diversity of the workforce (Health Careers Opportunity Program). Funding came from through both the American Recovery and Reinvestment Act (ARRA) and the Affordable Care Act. HHS Press Release

On Sept. 27, 2010 HHS awarded over $320 million in grants to support increased access to primary healthcare services through health professions education. HHS Press Release

Section 5305 - Establishes new programs related to education of health professions faculty regarding geriatric care and reauthorizes the geriatric education centers program.

Section 5307 - Establishes a grant program for the “development, implementation, and dissemination of research, demonstration projects, and model curricula for cultural competency, prevention, public health proficiency, reducing health disparities, and aptitude for working with individuals with disabilities…”

*No dedicated appropriations (Such sums as necessary)

Section 5315 - Establishes the United States Public Health Services Track to be implemented at health professions institutions selected by the Secretary “with authority to grant appropriate advanced degrees in a manner that uniquely emphasizes team-based service, public health, epidemiology, and emergency preparedness and response.” Eligible institutions include schools of pharmacy located within an academic health center.

*Requires the Secretary to transfer such sums as necessary from the Public Health and Social Services Emergency Fund for FY10 and subsequent years.

Section 5401 - Reauthorizes the diversity Centers of Excellence program and amends the formula for allocation of grants based on annual appropriations.

Section 5402 - Reauthorizes the Scholarship for Disadvantaged Students program and the faculty loan repayment and fellowship programs with increased appropriations through FY2015.

Section 5403 - Reauthorizes the Area Health Education Centers program. The legislation amends the existing law to emphasize the interprofessional health professions education expectations of the AHEC program. AHEC programs are required to “conduct and participate in interdisciplinary training that involves physicians, physician assistants, nurse practitioners, nurse midwives, dentists, psychologists, pharmacists, optometrists, community health workers, public and allied health professionals, or other health professionals, as practicable.”

This section also establishes a new grant program to support the continuing education of health professionals serving underserved communities through innovative methods including distance learning, collaborative conferences and telelearning activities.

On Sept. 30, 2010 HHS awarded $17 million in grants to support the development of new and maintenance of existing Area Health Education Centers (AHEC - $10 million) and the career development of geriatric specialists including pharmacy faculty ($5 million).

Section 5405 - Establishes the primary care extension program to support the development of patient-centered health homes through the work of community-based workers referred to as health extension agents.

Section 6301 - Establishes a patient-centered outcomes research program. Regularly referred to as comparative research, this approach to improving care quality and effectiveness will have a national research agenda established through the Patient-centered Outcomes Research Institute. PCOR will address issues related to medical services delivery including protocols for treatment, care management, and integrative health practices. The Institute is funded through appropriations and by a trust fund to which insurance companies will pay an annual amount. The Agency for Healthcare Research and Quality and the National Institutes of Health will provide the management for the Institute.

*PCORI released its first round of funding announcements, totalling $96 million. Applicants are asked to apply by July 31, 2012 and grants will be awarded in four topic areas: assessment of prevention, diagnosis, and treatment options; improving the healthcare system; better communicating the results of research; or addressing disparities. The online application system will open June 1, 2012.

The PCORI Board of Governors voted to amend PCORI’s January 2012 draft Research Agenda in response to 474 public comments and approved $30 million in funding over two years for a slate of 50 pilot projects. A full final version of the National Priorities and Research Agenda, including accepted revisions, will be posted May 21, 2012 after final Board review and approval at its next public meeting, in Denver. Information about future meetings and registration for the free meeting Webcast, are available.

The Comptroller General of the Government Accounting Office released the members of the Patient-centered Outcomes Research Institute (PCORI) on Sept. 23, 2010. GAO Press Release

The Sept. 30 edition of the Federal Register includes a notice of nominee solicitation for the PCORI Methodology Committee. Individuals interested should follow the instructions set forth in the notice.

Section 10607 - Authorizes the creation of state-level alternative approaches to tort litigation. Grant preference will be given to applicants that have engaged relevant stakeholders including healthcare providers and patient safety experts.

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