National Coalition on Care Coordination (N3C)

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National Coalition on Care Coordination (N3C) Origin: partnership between the New York Academy of Medicine and the American Society on Aging Outgrowth of a stakeholder conference in March 2008 Members include physicians, family caregivers, social workers, regulators, nurses, funders and researchers. All member organizations are engaged in policy services to older adults and their caregivers and have an interest in improving public policies related to care coordination.

Steering Committee Alzheimer's Association American Geriatrics Society American Society on Aging Consumer Coalition for Quality Health Care Matz, Blancato & Associates Medicare Chronic Care Practice Research Network National PACE Association New York Academy of Medicine Partners in Care Foundation

N3C Purpose To build consensus among stakeholder organizations and to advocate for enactment of public policies that support care coordination which effectively links health and long-term care on behalf of individuals with multiple chronic conditions with particular focus on older adults.

Core Elements N3C believes that care coordination should: be patient centered; be supportive of family and informal caregivers; be accessible; take an interdisciplinary approach; focus on chronic care and health care transitions; bridge health and social services; employ a comprehensive assessment; and, implement and monitor a flexible care plan.

N3C and Health Care Reform Used relevant research to validate views and inform the legislative process Met with Hill staff Communicated with the transition team and key legislative committees on the Hill Wrote letters Sponsored forums Shared information with N3C members and others

HCR Provisions for Care Coordination ( 2602) A new Coordinated Health Care Office at the Centers for Medicare and Medicaid Services to improve coordination and integration of benefits and services for individuals eligible for benefits under Medicare and Medicaid. ( 2703) A new Medicaid state plan option to provide Medicaid beneficiaries with chronic conditions with medical homes. ( 2704) A Medicaid demonstration project to evaluate integrated care around a hospitalization. ( 3021) Creation of the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS) to test innovative payment and service delivery models to reduce expenditures while preserving or enhancing quality of care. ( 3022) A Medicare Shared Savings Program to allow groups of providers who voluntarily meet certain criteria to work together to manage and coordinate care for Medicare fee-for-service beneficiaries through Accountable Care Organizations (ACOs). The Medicare Payment Advisory Commission (MedPAC) defines an ACO as a set of providers held responsible for the quality and cost of health care for a population of Medicare beneficiaries.

HCR Care Coordination Provisions, continued ( 3023) A national pilot program on payment bundling for integrated care. ( 3024) An Independence at Home Medical Practice Demonstration Program to use primary care teams to provide coordinated care to high-need populations at home. ( 3026) A Community-Based Care Transitions Program to fund hospitals and community-based partnership organizations to provide improved care transition services to high-risk Medicare beneficiaries. ( 3502) A grant program for establishment of communitybased, interdisciplinary teams to support primary care practices. ( 10333) A grant program to support community-based collaborative care networks.

N3C Implementation Advocacy Workgroups CHCO Center for Medicare & Medicaid Innovation Exchange Acting as a resource for implementation Educating CMS staff about care coordination N3C developing care coordination brief Meetings with officials to offer assistance and monitor implementation

Opportunities for Ongoing Advocacy Federal: Comments on proposed regulations Exchange comments October 4 Reauthorization of the Older Americans Act N3C Recommendations Ongoing advocacy with Congress State/Local: Involvement in shaping state-based Exchanges Formation of partnerships among stakeholders at the local level to assist in HCR implementation For example, between hospitals and HCBS/Aging Network

For More Information: Bob Blancato Email: rblancato@matzblancato.com Gail MacInnes Email: gmacinnes@consumers.org Brian Lindberg Email: brian@consumers.org