The following remarks were delivered by AcademyHealth, President and CEO, Lisa Simpson, MB, BCh, M.P.H., FAAP, at AcademyHealth's National Health Policy Conference on Monday, February 1 during the opening welcome.
Thank you, Lucy, and welcome to all of you. We are excited to be your hosts and thrilled with the program that Dr. Savitz and the planning committee helped assemble.
At AcademyHealth, our mission is to work alongside our members to improve health and the performance of the health system by supporting the production and USE of evidence to inform policy and practice. When you consider the different types of science in a continuum of health research, our field of health services research builds on the discoveries of basic and clinical science to determine how to deliver care and cures most effectively, with the highest level of quality, and in the most efficient way. That means looking at the thorny issues of health care costs, quality, access and equity with an eye toward generating applicable, relevant evidence for policymakers, health system leaders and patients.
Promoting the use of evidence takes many forms at AcademyHealth – and one way we support use is by creating space for thoughtful discussion and debate. This meeting is one of those spaces, and you are going to hear from experts representing a wide range of views, expertise, and different political ideologies throughout this meeting. We work hard to ensure a diversity of opinion, experience and perspective are represented across the agenda because we recognize that evidence-informed policy happens in an environment shaped by that other ‘p’ word – politics.
The questions and challenges you’ll discuss during this meeting also reflect the growing recognition that promoting and preserving health takes action well beyond ‘traditional’ health care. This shift to a broader, cross-sector view reflects the kinds of conversations our policymakers, and many of you, are having – discussions about the intersection of health, business, community, economics, environment, public safety, and our increasingly digitally connected world. Every policy decision has impacts – intentional or otherwise – that radiate to other sectors. Our field of health services research identifies, investigates and predicts those interactions so that policymakers from the delivery system, to states, to Capitol Hill can make informed decisions based on the outcomes they value.
We also support the translation of evidence into policy in other ways. This past year, AcademyHealth has been called upon to help policymakers put evidence in the context of real time decision making. An expert-led discussion on Value Based Insurance Design, or VBID, helped congressional staff working on legislation, which has since been introduced, understand how VBID can help reduce health disparities. A Hill briefing on cardiovascular diseases made clear how basic, clinical, and health services research act as reinforcing elements in a continuum of research. We convened experts to provide unbiased insight to policymakers at the Federal Trade Commission on what is being learned about the trends, impact and consequences of private sector consolidation. And always keeping an eye on state action, we worked with state-level policymakers through our partnership with the Medicaid Medical Directors Network and the State-University Partnership Learning Network to support states in finding and using evidence.
In addition to bringing evidence to policymakers, we work hard to make sure that researchers understand what information policymakers want and need. Today we released the third in our series of Listening Project reports, each of which engages decision-makers in a discussion of their data and evidence needs now and into the future. This year’s report zeroes in on the information and research needs of safety net health system leaders. Among its many conclusions are a pressing need for research that identifies effective strategies for transitioning from fee-for-service to value-based payment models, research that explores the impact of coverage expansions on both provider finances and patients’ access to care, and that research that helps providers effectively address patients’ non-medical needs. More information on that report is available on our home page.
These and other translation efforts do more than keep evidence front and center in policy debates – they demonstrate the myriad of ways health services research contributes to the quality of our national dialogue about how to promote, protect and preserve health for the greatest number of people, while also addressing the persistent challenges of managing costs and improving quality.
Unfortunately, we have been reminded, especially in this last year, that too often these contributions are either not seen, understood or valued. We have had to respond to increasingly serious threats to funding for health services research as well as rhetoric devaluing certain types of research, such as health economics research, other social science research and even patient centered outcomes research. This past June, a proposal to terminate the Agency for Healthcare Research and Quality was put forward as part of the 2016 congressional budget. We responded with an aggressive communications and advocacy campaign executed in partnership with the Friends of AHRQ coalition that we lead. Thought leaders from across the political spectrum including former Senate Majority Leader Bill Frist, Congresswoman Lucille Roybal Allard, Gail Wilensky, Joe Antos, Alan Weil and many others wrote opinion pieces defending the work of the agency, and advocates rallied.
Largely as a result of these efforts, final appropriations language in the omnibus spending package preserved AHRQ for another fiscal cycle, albeit with about a 10 percent funding reduction. This only makes our work over the next two days more critical as a tangible expression of the value of health services research. Evidence can and does inform policy and we believe this research is a public good that should receive robust federal support.
You may not agree with everything you hear today and tomorrow, and in fact I honestly hope you don’t. The translation of evidence into policy and practice requires a robust give and take of ideas. There is no single right way to achieve these ends. Curing the ills in our complex and costly health system requires thoughtful and often equally complex tradeoffs. This conference is your opportunity to dig into some of these most pressing challenges and tradeoffs, and to consider the evidence, experience and values that will inform this year’s policy decisions and its election rhetoric.
As you join in sessions, I encourage you to listen actively, and to debate respectfully, so that you leave this meeting better informed, better connected, and better prepared to use evidence to achieve the outcomes your organization seeks.
I also invite you to join us in our efforts to ensure sufficient, sustained federal support for health services research, for access to data, and for transparent dissemination of research results by becoming an AcademyHealth member – and, just as importantly, becoming an advocate for your own work by making a commitment to translate that work and share it broadly with the policymakers working diligently to improve our health and health care delivery system.
With that, I’d like to welcome one such policymaker to the stage. As Governor of Kentucky, Steve Beshear achieved something many thought impossible: a democratic governor in a heavily republican state, he successfully championed Medicaid expansion under the Affordable Care Act and his administration subsequently oversaw the successful role out of a state run health insurance exchange. Today, he joins us to share his perspective on the role of state policymakers, the politics of health reform and the future of health care coverage expansion.
Please join me in welcoming to the stage former Kentucky Governor Steve Beshear.