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October 18, 2017 IMPACT NEWSLETTER

Posted on 10/18/2017 by NTOCC ®

Technology: A Force Multiplier for Government Relations in Regards to Healthcare

                   IMPACT NEWSLETTER                     
                   FALL 2017                   

Technology: A Force Multiplier for Government Relations in Regards to Healthcare


For those who advocate on behalf of the needs of patients, there has never been a richer opportunity to stay abreast of policymaking and to influence policymakers. In this brief article we’ll look at why it’s critical to stay aware, and look at some new tools that can help monitor policy activity, synthesize myriad sources of information, and support coordinated advocacy efforts.

To start: you can’t influence what you don’t know about.

What you “need to know” can come from hundreds of sources. Congress has published more than 6,000 bills in the last 10 years that touch on healthcare; the 50 state legislatures have increased the pace of their legislative activity as gridlock has paralyzed Congress; hundreds of regulations are published daily in the Federal Register; Members of Congress are publishing press releases; politicians are posting on social media, now the fastest way to reach their constituents.

And the need to act is almost instant. A few states have legislative sessions as brief as 10 days, during which time legislation is introduced, debated, and passed. If you don’t know that the legislation is being discussed, you can’t be at the table to influence it. If you miss a federal bill that impacts your patients’ well being, you can’t develop mitigating strategies for when the bill hits the floor, or, ultimately, the Oval Office.

We have seen companies bridge the Silicon Valley world of technology with the world of policy to help advocates stay informed and ahead of the process. At NTOCC, we and some of our members have adopted one such platform, GovPredict, to centralize disparate information, identify threats and opportunities, address significant paint points, and empower our advocates.

Once something is in the news or hits Google, it is often too late. Companies like GovPredict will take a keyword like “tele-health” or “transition of care,” and find mentions in politicians’ social media, – which often helps identify unknown allies – in politicians’ press releases, in federal, state, and local legislation, in regulations, in lobby disclosure reports, and even think tank research. Think tank research helps anticipate legislative trends in the future; searching thousands of lobby disclosure reports in seconds helps find valuable allies in legislative fights.  And being the first to know about a Facebook post sometimes means being the first to inform your stakeholders.

Tools like GovPredict aren’t merely document repositories and alert systems. They come with a grassroots platform, so that a new state bill concerning tele-health can be converted into a call to action for your advocates in a matter of minutes. They come with fly-in tools so that your Hill days can be successful, and with a customer relations management (CRM) system, to be able to record meetings with policy makers and internally, to improve efficiency. They even come with social graphs of politicians, to suggest which politicians are most likely to champion specific pieces of legislation. And they will come with productivity tools to turn 5 hour projects into 10 minute projects and free up time for pursuing advocacy efforts. We have already been able to better serve the communities we represent, created greater productivity in disseminating information, and improved communication to the Hill, agencies and other entities addressing similar issues.

New technology platforms like GovPredict have also given advocacy communities the ability to create campaigns and messages that are targeted to specific audiences. This customization significantly improves accuracy and success.  Such modern technology allows swift action; cumbersome systems of the past had handicapped organizations from reaching members or entities in a timely fashion.  As the Patient Protection and Affordable Care Act implementation and reform efforts continue simultaneously, Congress and the Administration have a great deal of latitude to implement pilot programs and initiatives that can have a potential impact on patient care for decades to come. For patient advocates, there is no excuse to be under informed, under prepared, or lacking the technological resources to influence the next decades of patient care.

The federal, state, and municipal levels all have an impact on the care delivery system. And while the use of available and accessible data to help advocates is not a new concept, we have seen recently seen simple legislative monitoring technology transform into complete platforms for influencing public policy. Platforms such as GovPredict and others are indispensable tools and resources for all advocacy communities. In the same way as the healthcare community is seeing the integration of new technologies in all healthcare delivery settings, it is important to educate and adopt the same in our advocacy efforts as we continue to strive for better patient centered care.

For additional information on how to find out about technology like this you can visit  

NTOCC will host a webinar with GovPredict   
on October 30, 2017
 11am CDT/12pm EDT
Webinar Meeting Link:
Dial-in Number*: (515) 739-1513
Access Code: 986228
Online Meeting ID: ntocc

Sample Twitter feeds for Congressional Members that can be pulled from GovPredict searches.

NTOCC Policy & Advocacy Corner

2017 has been an interesting year on the Hill thus far.  While much of the country was preoccupied with the first 100 days into President Trumps Presidency, Summer Recess and appropriations, NTOCC has been watching the movements regarding transitions of care, care coordination, re-admissions and just healthcare in general between Congress and the White House.

NTOCC has recently Partnered with GovPredict, and we have been monitoring Healthcare across government agencies using, this very unique platform in which you can read about in the above article. We will also have a webinar for those interested on Monday, October 30, 2017 at 11am CDT.  We have added the webinar info for you in the "Upcoming Events" section as well as the article above from GovPredict.

Some of the Bills we are currently tracking in regards to the NTOCC Community right now are listed below.   Congress has been on a recess so they are just getting back to the Agenda, which is heavily loaded down already with Healthcare, tax reform, hurricane relief, and the National Defense Authorization Act for fiscal year 2018 which has just easily passed in the Senate 89-8, but now it is in the hands of the House of Representatives to hammer out.

Feel free to let Val Emmons know if your organization would like to have a particular bill of concern for you in your sector of the healthcare continuum monitored.

H. R. 3611 To amend title XVIII of the Social Security Act to create incentives for healthcare providers to promote quality healthcare outcomes, and for other purposes.

H. R. 3495 To amend the 21st Century Cures Act to appropriate funds for the Account for the State Response to the Opioid Abuse Crisis through fiscal year 2023, and for other purposes.

H. R. 3254 To amend the Internal Revenue Code to impose an excise tax on opioid manufacturers, to make the funds collected through such tax available for opioid (including heroin) abuse prevention and treatment programs, and for other purposes.

H. R. 3461 To amend the Older Americans Act of 1965 to develop and test an expanded and advanced role for direct care workers who provide long-term services and supports to older individuals in efforts to coordinate care and improve the efficiency of service delivery.

 S. 1771--Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2018, and for other purposes.

➤ S. 870. A bill to amend title XVIII of the Social Security Act to implement Medicare payment policies designed to improve management of chronic disease, streamline care coordination, and improve quality outcomes without adding to the deficit.

S. 1606 To authorize grants for the support of caregivers. 
This Act may be cited as the ‘‘In-Home Caregiver Assessment Resources and Education Act’’ or the ‘‘In- Home CARE Act’’.

➤ (S. 920) to establish a National Clinical Care Commission.

➤ S 1754 (115)

This Act may be cited as the Training the Next Generation of Primary Care Doctors U.S.C. 256h) was enacted in 2010 to address the crisis-level shortage of primary care physicians faculty will provide more than one million primary care medical visits in 2017 to underserved health centers are more likely to practice primary care and remain in underserved or rural communities generation of primary care physicians (including dentists), but helps bridge the Nation’s physician

H. CON. RES. 71  Establishing the congressional budget for the United States Government for fiscal year 2018 and setting forth the appropriate budgetary levels for fiscal years 2019 through 2027.

Please share your comments or concerns with us via email ( on any of the bills we are monitoring so we may pass this information onto the legislators who are introducing and sponsoring them in the House and Senate. NTOCC also encourages individuals to reach out to their elected officials to advocate for improved care transitions in Medicare and Medicaid.


Presidential Executive Order Signed In hopes of Promoting Healthcare Choice and Competition Across the United States

On October 12, 2017 in Washington, D.C., President Trump signed the Presidential  Executive Order Promoting Healthcare Choice and Competition Across the United States* in the hopes of this being the first step to beginning reform to the current healthcare system.  The President believes that by working to expand choices and alternatives to  The Patient Protection and Affordable Care Act (PPACA) health insurance plans, and by increasing competition of providers across state lines, that costs for consumers will be dramatically lowered.

The order directs the Secretary of Labor to consider expanding access to Association Health Plans (AHPs), which could potentially allow American employers to form groups across State lines.  By providing a broader interpretation of the Employee Retirement Income Security Act (ERISA), employers in the same line of business anywhere in the country could potentially be allowed to join together to offer healthcare coverage to their employees.  This could potentially allow employers to form AHPs through existing organizations, or create new ones for the express purpose of offering group insurance.  By making it easier for employers to band together, workers could have access to a broader range of insurance options at lower rates in the large group market.  Employers participating in an AHP cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions.

The Executive Order also directs the Departments of the Treasury, Labor, and Health and Human Services to consider expanding coverage through low cost short-term limited duration insurance (STLDI). STLDI is not subject to costly ACA mandates and rules. One study found that on average STLDI costs one-third the price of the cheapest PPACA plans. Despite its low cost, STLDI typically features broad provider networks and high coverage limits.  The main groups who benefit from STLDI are people between jobs, people in counties with only a single insurer offering exchange plans, people with limited coverage networks, and people who missed the open enrollment period but still want insurance.

The order further directs the Departments of the Treasury, Labor, and Health and Human Services to consider changes to Health Reimbursement Arrangements (HRAs) so employers can make better use of them for their employees.  HRAs are employer-funded accounts that reimburse employees for healthcare expenses, including deductibles and copayments. The IRS does not count funds contributed to an HRA as taxable income and HRAs could potentially give American workers greater flexibility and control over how to finance their healthcare needs.

According to the October 12, 2017 White House Press release, the most recent Patient Protection and Affordable Care Act (PPACA) statistics show that:

• The percentage of workers at small firms receiving coverage through their employer has declined from nearly half in 2010 to about one-third in 2017.

• In 2018, more than 1,500 counties (nearly 50 percent of all counties) are projected to have only one option on their individual insurance exchanges, according to the Centers for Medicare and Medicaid Services.  This means 2.6 million Americans, or nearly 30 percent of exchange participants, will be left without a choice of insurers.

• From 2013 to 2017, average premiums for individual health insurance plans have doubled, increasing by $2,928 according to the Department of Health and Human Services.  During this period, every State using saw individual insurance premiums increase.

• Americans are departing the ACA exchanges and millions are choosing to pay the law’s penalty instead. 500,000 fewer Americans enrolled in an ACA plan in 2017 compared to the prior year.  Whereas the current exchange enrollment is 60% below what the Congressional Budget Office expected when the law took effect.  6.7 million Americans chose to pay the Obamacare penalty in 2015 rather than purchase insurance on the exchanges. 37% of penalized households made less than $25,000, and 79% of penalized households made less than $50,000.

The Trump Administration officials say that they do not expect any new regulations to be implemented before the end of the year.  

* Information taken from White House Press Release; "President Donald J. Trump is Taking Action to Improve Access, Increase Choices, and Lower Costs for Healthcare"



GovPredict Webinar
October 30, 2017 

Webinar Meeting Link:
Dial-in Number*: (515) 739-1513
Access Code: 986228
Online Meeting ID: ntocc

Lunch & Learn WEBINAR #3
Please join us for the third and final webinar in the 2017 NTOCC Lunch & Learn series.  
 November 30, 2017
12pm-1:00pm CST/1pm-2pm EST
"Transitions of Care Quality Measurement"
Presented by by Norris Turner, Johnson & Johnson

Webinar Meeting Link:
Dial-in Number*: (515) 739-1513
Access Code: 986228
Online Meeting ID: ntocc

The management of effective care transitions for individuals and populations of patients with behavioral health conditions, particularly those with serious mental illness, is of critical importance.  This webinar will introduce the driving forces behind ineffective care transitions in behavioral health, and discuss important value-based care policy, payment and practice paradigm shifts underway to effect positive change in care transitions in behavioral health.  An area of particular focus in the webinar will be the role of quality measurement in impacting transitions of care in behavioral health.



Dear NTOCC Community,

Transitions of care continues to be a focus of concern for many providers as we look to improving clinical outcomes and reducing avoidable hospital readmissions.  Legislation and regulations affecting the delivery of healthcare to Americans, both at the Federal and State levels, is a constant evolution.  No matter whether you do or do not support current policy changes or new regulations we still must focus on how we improve the patient’s journey through the healthcare maze.  A major focus for all of us is to stay aware and knowledgeable regarding policy and regulatory issues.  To that end, I hope you will join us on October 30th for a review regarding how we can follow the many legislative initiatives that help to shape our interactions and clinical practice in the delivery of healthcare today.

NTOCC continues to support the need for strong collaborative care teams focused on improving medication management, patient education and engagement, transition planning, information transfer, follow-up care, healthcare provider engagement and shared accountability across providers and organizations.   NTOCC created the Care Transitions Bundle; Seven Essential Intervention Categories to assist providers in implementing programs that address the many gaps and barriers to improving transitions.  The Care Transition Bundle can be found at  Over the next few months I would like to highlight several of the intervention categories and discuss specific interventions that enhance communication and outcomes for patients, family caregivers and providers.

In this issue, I would like to turn the focus on patient and family engagement/education.   Patients and families/caregivers should be knowledgeable regarding their condition and their plan of care.  They need to understand the symptoms that indicate their condition is worsening, and learn how to respond using knowledge of “red flags”.  Providing this education requires that we must understand our patients and their family caregivers “health literacy” and be sure that we are addressing the health literacy with the materials and language we use in discussing various options.  

Positive patient engagement includes Shared Decision Making (SDM).  SDM is a process of communication in which clinicians and patients work together to make optimal healthcare decisions that align with what matters most to patients.  This alignment helps to build trust, respect and adherence to treatment options that are supported in the patient’s care plan.  The National Quality Forum has a “call to action” asking us to embrace and integrate shared decision making into clinical practice as a standard of person-centered care.  They have released a brief which highlights the components of SDM.  This important information can be found in the publication titled the National Quality PartnersTM Action Brief – Shared Decision Making A Standard of Care for All Patients.  

You can review the brief at: 

No one discipline is solely responsible for SDM but together as a collaborative care team we can improve not only communication but engagement with our patients and their family caregivers.

Let us know if you have Shared Decision Making tools that we can share with the NTOCC Community and help move this “call to action” forward with NQF.


Cheri Signature.jpg                                                                                                                                                                                                                                              Cheri Lattimer

Executive Director


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