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Inaugural Advocacy Interest
Group Meeting

                       J une 25, 2012
We Can’t Do It Alone
 AcademyHealth promotes HSR in the
  nation’s capital
 Advocacy is a team sport

 The users and producers of HSR are

  the best advocates
 AcademyHealth will provide the tools

  you need to be an effective advocate
Goal: Advocates and Ambassadors

   By the end of today’s meeting, you will
    know:
    – How AcademyHealth engages in advocacy
    – How the Advocacy Interest Group will
      bolster these efforts
    – What we’re facing in Washington
   You will be prepared to share your
    knowledge and recruit other advocates
Workshop Overview

   Advocacy at AcademyHealth
    –The Role of the Interest
     Group
   The Current Policy Environment
    – A Time of Uncertainty
   Discussion & Next Steps
Recent History
 Advocacy previously through separate
  Coalition for Health Services Research
 October 2011 AcademyHealth Board

  conducted assessment of relationship
 December 2012 voted to consolidate

  advocacy into AcademyHealth
    – Established Committee on Advocacy and
      Public Policy (CAPP)
Our Advocacy Principles
 Advocate for science policy
 Monitor the environment for trends

  important to members, stand to shape
  field through policy change
 Engage our members, affiliates,

  partners
 Collaborate to inform priorities and

  respond to community’s needs
Our Advocacy Priorities
   Increasing federal funding for HSR
    – Balance in what is funded, who is funded,
      and how its funded
   Building a robust environment to
    produce HSR
    – Preserve scientific integrity, protect human
      subjects, enhance data availability
   Enhancing HSR dissemination, use
Interest Group’s Goals
 AcademyHealth’s IGs provide forum for
  interaction around shared interests
 Advocacy IG will cultivate “grassroots”

  community by:
    – Planning and facilitating annual “advocacy
      institute” at ARM
    – Hosting 1-2 advocacy webinars per year
    – Participating in annual “Hill Day”
   Lou Rossiter to serve as first chair
Workshop Overview
   Advocacy at AcademyHealth
    – The Role of the Interest Group
   The Current Policy Environment
    – A Time of Uncertainty
   Discussion & Next Steps
HSR Funding: Survival Mode
   HHS funding reduced by 5% since
    FY10, on average
    – AHRQ base cut 8%since FY10
    – AHRQ cut 40% accounting for lost
      Recovery Act capacity
    – NIH roughly flat funded; 25% accounting
      for Recovery Act
HSR Funding: Survival Mode
   Affordable Care Act funding helps
    backfill AHRQ cuts
    – Patient –Centered Outcomes Research
      Transfer
       • $24 million in FY12; $62 million in FY13 to
         AHRQ
    – Prevention and Public Health Fund
       • $12 million to AHRQ annually since FY10
       • $35 million to NCHS annually since FY 11
HSR Funding: FY13 Outlook
   Senate spending bill preserves public
    health, research funding
    – AHRQ base cut 1.5%...but…
       •   President requested 9.5% cut
       •   PCOR Fund used to supplement, not supplant
       •   $43 mil for grants; President cut by $20 mil
       •   All AcademyHealth report language included
 NCHS flat funded
 NIH increased $100 million
HSR Funding: FY13 Outlook
 House spending bill expected to gut
  public health, research funding
 House FY12 proposal…

    – Increased NIH by $1 billion but
    – Rescinded all Affordable Care Act funding
    – Cut AHRQ by 13 percent
   House FY13 allocation $8 billion less
    than Senate
Other Threats
   SCOTUS ruling June 28ish
    – Could impact PCORI, Prevention Fund,
      Center for Medicare and Medicaid
      Innovation
   Election
    – Republican trifecta would repeal (and
      replace?) Affordable Care Act
   Sequestration!
Budget Control Act
   Two-phase debt ceiling increase
    – Phase 1: $900 billion through end of 2011
    – Phase 2: $1.2-$1.5 trillion through
      November 2012
   Increases contingent upon offsets
    – Phase 1 offset: discretionary caps over
      decade
       • FY 2013 capped at $1.047 trillion
    – Phase 2 offset: determined by
      “supercommittee”
Budget Control Act
 Bicameral, bipartisan committee to
  identify $1.5 trillion in savings
 If Congress does not enact, sequester

  takes effect January 2013
    – Across the board spending cuts of 8 – 12
      percent
    – Social Security, Medicaid, and low-income
      support programs exempt
The Price of Failure
 Across-the-board cuts in 2013
 $984 billion cut over 10 years, or $109

  billion annually
 Cuts equally divided between defense

  and non-defense
The Fiscal Cliff
   Continuing resolution(s)/omnibus
    – House lowers nondefense discretionary by $27 billion,
      despite bipartisan Budget Control Act
   Sequester
    – Is threat to defense spending enough to force meaningful
      deficit reduction plan?
   Bush tax cuts expire
   “Extenders” package expires
    – Unemployment benefits, payroll tax holiday, Medicare
      physician payment fix
   Debt ceiling
We Need Your Voice
 AcademyHealth working with
  community to avert sequestration
 Members of Congress need to hear

  from you:
    – Sequester is unacceptable
    – Research is important, core gov’t function
    – Balanced approach to deficit reduction
   AcademyHealth will share tools to
    help you

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Advocacy Interest Group Inaugural Meeting

  • 1. Inaugural Advocacy Interest Group Meeting J une 25, 2012
  • 2. We Can’t Do It Alone  AcademyHealth promotes HSR in the nation’s capital  Advocacy is a team sport  The users and producers of HSR are the best advocates  AcademyHealth will provide the tools you need to be an effective advocate
  • 3. Goal: Advocates and Ambassadors  By the end of today’s meeting, you will know: – How AcademyHealth engages in advocacy – How the Advocacy Interest Group will bolster these efforts – What we’re facing in Washington  You will be prepared to share your knowledge and recruit other advocates
  • 4. Workshop Overview  Advocacy at AcademyHealth –The Role of the Interest Group  The Current Policy Environment – A Time of Uncertainty  Discussion & Next Steps
  • 5. Recent History  Advocacy previously through separate Coalition for Health Services Research  October 2011 AcademyHealth Board conducted assessment of relationship  December 2012 voted to consolidate advocacy into AcademyHealth – Established Committee on Advocacy and Public Policy (CAPP)
  • 6. Our Advocacy Principles  Advocate for science policy  Monitor the environment for trends important to members, stand to shape field through policy change  Engage our members, affiliates, partners  Collaborate to inform priorities and respond to community’s needs
  • 7. Our Advocacy Priorities  Increasing federal funding for HSR – Balance in what is funded, who is funded, and how its funded  Building a robust environment to produce HSR – Preserve scientific integrity, protect human subjects, enhance data availability  Enhancing HSR dissemination, use
  • 8. Interest Group’s Goals  AcademyHealth’s IGs provide forum for interaction around shared interests  Advocacy IG will cultivate “grassroots” community by: – Planning and facilitating annual “advocacy institute” at ARM – Hosting 1-2 advocacy webinars per year – Participating in annual “Hill Day”  Lou Rossiter to serve as first chair
  • 9. Workshop Overview  Advocacy at AcademyHealth – The Role of the Interest Group  The Current Policy Environment – A Time of Uncertainty  Discussion & Next Steps
  • 10. HSR Funding: Survival Mode  HHS funding reduced by 5% since FY10, on average – AHRQ base cut 8%since FY10 – AHRQ cut 40% accounting for lost Recovery Act capacity – NIH roughly flat funded; 25% accounting for Recovery Act
  • 11. HSR Funding: Survival Mode  Affordable Care Act funding helps backfill AHRQ cuts – Patient –Centered Outcomes Research Transfer • $24 million in FY12; $62 million in FY13 to AHRQ – Prevention and Public Health Fund • $12 million to AHRQ annually since FY10 • $35 million to NCHS annually since FY 11
  • 12. HSR Funding: FY13 Outlook  Senate spending bill preserves public health, research funding – AHRQ base cut 1.5%...but… • President requested 9.5% cut • PCOR Fund used to supplement, not supplant • $43 mil for grants; President cut by $20 mil • All AcademyHealth report language included  NCHS flat funded  NIH increased $100 million
  • 13. HSR Funding: FY13 Outlook  House spending bill expected to gut public health, research funding  House FY12 proposal… – Increased NIH by $1 billion but – Rescinded all Affordable Care Act funding – Cut AHRQ by 13 percent  House FY13 allocation $8 billion less than Senate
  • 14. Other Threats  SCOTUS ruling June 28ish – Could impact PCORI, Prevention Fund, Center for Medicare and Medicaid Innovation  Election – Republican trifecta would repeal (and replace?) Affordable Care Act  Sequestration!
  • 15. Budget Control Act  Two-phase debt ceiling increase – Phase 1: $900 billion through end of 2011 – Phase 2: $1.2-$1.5 trillion through November 2012  Increases contingent upon offsets – Phase 1 offset: discretionary caps over decade • FY 2013 capped at $1.047 trillion – Phase 2 offset: determined by “supercommittee”
  • 16. Budget Control Act  Bicameral, bipartisan committee to identify $1.5 trillion in savings  If Congress does not enact, sequester takes effect January 2013 – Across the board spending cuts of 8 – 12 percent – Social Security, Medicaid, and low-income support programs exempt
  • 17. The Price of Failure  Across-the-board cuts in 2013  $984 billion cut over 10 years, or $109 billion annually  Cuts equally divided between defense and non-defense
  • 18. The Fiscal Cliff  Continuing resolution(s)/omnibus – House lowers nondefense discretionary by $27 billion, despite bipartisan Budget Control Act  Sequester – Is threat to defense spending enough to force meaningful deficit reduction plan?  Bush tax cuts expire  “Extenders” package expires – Unemployment benefits, payroll tax holiday, Medicare physician payment fix  Debt ceiling
  • 19. We Need Your Voice  AcademyHealth working with community to avert sequestration  Members of Congress need to hear from you: – Sequester is unacceptable – Research is important, core gov’t function – Balanced approach to deficit reduction  AcademyHealth will share tools to help you