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If you take an interest in health policy and regulation, you probably keep an eye on the Centers for Medicare & Medicaid Services (CMS). After all, CMS regulates programs that deliver most of the revenue for the typical long-term care pharmacy. The agency tells us how our customers get paid under Medicare Part A and how we work within Medicare Parts B and D. Staying in touch with CMS is fairly simple. The agency offers many listservs that automatically send subscribers information on a host of different programs. To get started, go to the email updates web page.

The ACL (Not the Anterior Cruciate Ligament)

We all recognize that eldercare continues to move away from institutional care and toward more home and community-based services (HCBS). Although Medicaid is the agency responsible for administering the HCBS program, the Administration for Community Living (ACL), another agency within the Department of Health and Human Services (HHS), is very active in promoting and facilitating non-institutional living for the elderly and the disabled. Get on the ACL mailing list for informative updates on this important topic.

The CDC: Not Just COVID

Formerly an obscure agency within the HHS, the Centers for Disease Control and Prevention (CDC) became more famous during the COVID-19 pandemic. You may know it as the agency in control of shutting down public spaces, but if you want to be among the first to know about infections raging within specific populations, be sure to subscribe to the CDC’s Morbidity and Mortality Weekly Report. Their data files are also important sources of public health information.

Don’t Know ASPE? You Should

The HHS Assistant Secretary for Planning and Evaluation (ASPE) sounds as dry as dust. Not much going on here? Look again. This is the place where much of federal health policy is born and nurtured, and regular look-ins at its website can keep you updated on what administration officials are thinking about. ASPE even has specialized offices directly related to our area of expertise: The Division of Disability and Aging Policy and the Division of Long-Term Services and Supports.

Quality Begins at the Ark

Often referred to as “Ark,” the Agency for Healthcare Research and Quality (AHRQ) is a storehouse of health data across a broad range of healthcare specialties and topics. AHRQ has an impressive amount of material dedicated to nursing home staff training and one of the most comprehensive data sets within the federal government. The data take a bit of training to retrieve, but AHRQ regularly holds training sessions on how to access and work with the data. Keep checking in with AHRQ to stay on top of trends.

See Why Everyone Loves NIH

Unlike the Internal Revenue Service, the National Institutes of Health (NIH) is a very popular federal agency – not just popular with the public, but with Congress as well. The budget of this massive health research complex is $45 billion, most of which is spent studying various diseases across 20 separate institutes. One you might be very interested in is the National Institute on Aging. Go here to discover the latest research on diseases common to the elderly and information for patients on important health topics.

MedPAC: Don’t Understand Medicare as Well as You Would Like? Start Here.

We could go on for a long time, but we’ll wrap up with a mention of the Medicare Payment Advisory Commission (MedPAC). Unlike the other agencies we’ve covered, MedPAC is not within the HHS. It’s an independent body that answers to Congress, and its primary mission is to advise Congress on the Medicare program and issues related to provider payment and quality. A hidden gem in the MedPAC website is the section on Payment Basics, which gives a comprehensive explanation of how providers in each Medicare program are paid.

These are a few of the many federal agencies that create policy and issue reports on healthcare issues. The U.S. government pays for just over one-third of all healthcare in the country, and its access to data and research are unequaled. Almost all the information and data are free.

Take a tour of these websites and perhaps subscribe to the agencies’ newsletters or get on their listserv so announcements are pushed to your inbox.

X-factors for Keeping Up with Government Agencies

  • Check out the agency website and make note of what kind of information is available.
  • Get on the agency’s mailing list for announcements and newsletters.
  • Reach out to agency staff if you have questions. They are routinely quite accessible and are among the most knowledgeable on their issues.

Do you find keeping up with policy trends pays dividends for your pharmacy business? Are there any agencies we missed that you find important or useful to follow? Share your thoughts!

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Written by: Paul Baldwin, Baldwin Health Policy Group
Paul’s pharmaceutical industry experience in public and government affairs led to becoming Executive Director of the Long Term Care Pharmacy Alliance, helping lead the industry through the Medicare Modernization Act and creation of the prescription drug benefit. Paul was VP of Public Affairs for Omnicare before founding Baldwin Health Policy Group.

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