Top Public Policy Priorities for the AGS

Promoting a more comprehensive, less fragmented healthcare system, advocating for needed Medicare reforms, addressing the shortage of academic healthcare professionals specializing in geriatrics, and supporting research to improve healthcare design are crucial to improving care for older adults in long-term care and other settings. Convening in early May during the American Geriatrics Society’s annual meeting, the AGS Board of Directors voted to make the above the Society’s top public policy priorities for the coming year. It also adopted a slate of strategies aimed at realizing these aims. The board developed both based on discussions during the annual meeting and a two-day public policy planning session in March. The March meeting, which included AGS and Association of Directors of Geriatric Academic Programs board members and leaders involved in public policy issues, was the first of what will be annual AGS public policy planning sessions.

Obviously, public policy has an enormous impact on the healthcare that older people receive, whether they’re residents of LTC facilities or the community. The fragmented nature of the nation’s healthcare system, inadequate Medicare reimbursement, other disincentives to pursuing clinical and academic careers in geriatrics, and practice design problems are clearly obstacles to providing quality care. Inadequate reimbursement, among other things, continues to make recruiting health professionals into long-term care, and retaining them, a significant challenge.

The approaches AGS’ board adopted to address these obstacles are wide ranging. Strategies for promoting a more comprehensive patient-centered, less fragmented healthcare system, for example, include stepped-up advocacy efforts on behalf of the Geriatric Assessment and Chronic Care Coordination Act (GACCCA), which would authorize coverage of geriatric assessments and care coordination for fee-for-service Medicare beneficiaries with multiple chronic conditions. They also include: efforts to influence the design of universal healthcare proposals by, among other things, working with other stakeholders, including presidential candidates; and efforts to play a larger role in initiatives aimed at establishing standards such as those for pay-for-performance programs.

Strategies for reforming the way Medicare calculates payments for services provided to beneficiaries include becoming more active in the RUC/CPT arena; working with legislators, particularly those involved in healthcare issues; and leveraging a recently launched Institute of Medicine (IoM) consensus study examining the extent to which the nation’s healthcare workforce is prepared to care for the rapidly increasing number of older Americans, and how best to improve care. A report on the IoM study, which should significantly raise awareness of these concerns, is due out in March 2008.

Additional advocacy on behalf of initiatives—such as Title VII Geriatrics Health Professions Programs, and the Nurse Education, Expansion and Development Act—aimed at increasing the number of geriatrics healthcare professionals are among the strategies the AGS board endorsed to help recruit promising candidates into the field and foster the careers of the next generation of academic geriatrics professionals. T

hese efforts are already yielding results. Legislators in both the House and Senate introduced the GACCCA in late May, and the Senate convened a hearing to examine the need for care coordination for beneficiaries with multiple illnesses, such as diabetes, arthritis, heart disease, and dementia. The Society continues to work closely with the prime sponsors introducing the bill, Sen. Blanche Lincoln (D-AK) and Rep. Gene Green (D-TX). AGS President Todd Semla, PharmD, testified at the Senate hearing. The Society has also reached out to other stakeholders. By late May, the GACCC Act had won the endorsement of 32 national organizations, including the American College of Physicians, the American College of Nurse Practitioners, the National Association of Social Workers, and the National Rural Health Association.

AGS has already launched grassroots advocacy campaigns urging Congress to both increase funding for Title VII Geriatrics Health Professions Programs in Fiscal Year 2008, which begins October 1, and ensure passage of the “Keeping Seniors Safe From Falls Act of 2007.” The Society is now planning campaigns on behalf of other priorities at the top of its list for the coming year. Your help will be vital to the success of these campaigns. I urge you to join us in our work to influence policy in ways that improve healthcare for older adults by visiting the AGS Foundation for Health in Aging Advocacy Center (https://www.healthinaging.org/advocacy/), joining the Title VII and falls campaigns, and registering with the Center so that we can alert you to future campaigns. I also urge you to use the Center’s “Tell a Friend” feature to spread the word and encourage others to advocate for public policy that enhances the care of older people in long-term care and our communities. The more likeminded advocates we engage, the greater our odds of achieving these important goals and ensuring older Americans access to quality care.