Impact of Health Care Reform on the Future of Nutrition and Dietetics Understanding the changes to create new nutrition opportunities Pepin Andrew Tuma, JD Director, Regulatory Affairs Academy of Nutrition and Dietetics 10/15/2014
Objectives Discuss disparities in accessing health that are at the basis of change Understand that ACA creates a structure and opportunities, but few guarantees Explain goal/role of prevention Explain changes in delivery and payment models Understand how the registered dietitian nutritionist (RDN) can be an integral team member Identify opportunities for the RDN 2
Disparities in Healthcare Access Limited access to healthcare Limited access to qualified practitioners Inability to afford healthcare Higher rates of chronic diseases 3
CMS s Triple Aim Better healthcare by improving all aspects of patient care Better health by encouraging healthier lifestyles in the entire population Lower costs through improvement by promoting preventative medicine 4
ACA Goals: Transform Healthcare -Fee-for-service -Limited Access -Costly -Duplicative procedures Affordable Care Act -Prevention -Health IT -Increased Access -Incentives -Medicaid Expansion 5
Increasing Access CMS Free Preventive Services No more co-pays Medicare Medicare Annual Wellness Visit (AWV) Intensive Behavioral Therapy (IBT) for Obesity, CVD disease Medicaid Expansion Expanded Preventive Care Services As recommended by USPSTF Included as Essential Health Benefits 6
Increasing Access Health IT Telehealth & Electronic Health Records Increasing public knowledge Menu and Calorie Labeling New Initiatives to Transform Access Community Transformation Grants Prevention and Public Health Fund; Programs Community Health Centers 7
Increasing Access Community Transformation Grants Requires ideas, application, and expertise To address health disparities & reduce chronic diseases Healthy living Tackle social and economic causes of poor health Specific activities suggested include: Increasing access to nutritious foods Creating healthier school environments Expanding worksite wellness programs 8
Focus on Prevention Healthy Aging, Living Well CDC Grant Program Targets 55-64 year olds Provide public health community interventions, screenings, and clinical referrals Improve health of an aging population Child Obesity Demonstration Project - $25 million Children s Health Insurance Program (CHIP) Children 2-12 years Improve nutrition and physical activity Identify effective healthcare and community strategies to combat childhood obesity 9
Focus on Prevention Putting Prevention to Work - $74 million Tobacco control Obesity prevention HIV-related health disparities Better nutrition and physical activity Primary and Behavioral Health Integration - $20 million Coordinate & integrate primary care services into community health settings Obesity Prevention and Fitness - $16 million Promoting healthy lifestyles through improved nutrition and increase physical activity Tobacco Cessation - $16 million Anti-tobacco media campaigns 10
Transforming the System Patient-Centered Medical Homes Medical teams providing coordinated treatment Accountable Care Organizations Network of doctors and hospitals required to provide care for Medicare beneficiaries Comprehensive Primary Care Initiative A multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care 11
Bundled Payments Single payment Said to improve both cost and quality Shift from rewarding utilization to inducing good outcomes Align payers and providers Research w/ policy application is critical Requires playing fair in the sandbox 12
Center for Medicare & Medicaid Innovation Test new payment and service delivery models Evaluate results Preserve and enhance quality of care Advance best practices Stakeholder buy-in 13
ACA Provisions: Opportunities for RDNs Healthy Aging, Care Management Employee Wellness & Prevention Child Nutrition School-based health Reducing Childhood Obesity U.S. and Community Preventive Services Task Forces Enhanced Access via Medicare, Medicaid, and Private Plan Preventive Services Home Health Medical Homes; Medical Neighborhood 14
Seizing the Opportunities Ahead Get there first seek out grants Make competitors collaborators Develop competencies to create unique niche Know others scope of practice Business, Policy Health IT Outcomes Own the word Nutrition 15