Medicare bill holds key to delivering a bipartisan health care win

If the news stories are to be believed, Congress cannot agree on much of anything when it comes to health care. The botched effort to repeal and replace the Affordable Care Act made for big headlines and appeared to leave lawmakers and the public with little hope for acts of bipartisanship anytime soon.

But that narrative tells half the story. In truth, Republicans and Democrats successfully worked together just last month, when Congress overwhelmingly passed sweeping, long-term legislation to reauthorize user fee agreements that account for much of the Food & Drug Administration’s (FDA) funding.

{mosads}Congress would prove the naysayers wrong last year, too, when it passed the 21st Century Cures Act, legislation signed into law by then-President Obama streamlining drug approval processes and bolstering research for breakthrough treatments and therapies.

Democrats and Republicans alike know that Washington needs another bipartisan victory of this sort, and the answer is right under their nose.

Medication adherence – the practice of ensuring patients take their drugs as prescribed – isn’t exactly the hot topic du jour in today’s health care debate. You won’t hear it mentioned in campaign commercials, and it doesn’t make for the best fundraising pitch. After all, everyone agrees people should stick to their meds, right?

But it isn’t working out that way in practice. Suboptimal use of prescription medications is the $300 billion problem that few are talking about – and it’s claiming the lives of 125,000 Americans a year, leading the New York Times to deem this issue an “out-of-control epidemic … that costs more and affects more people than any disease Americans currently worry about.”

Recently, a bipartisan group of lawmakers – Republican Representatives Lynn Jenkins (R-Kan.) and Gregg Harper (R-Miss.) and Democrat Representatives Mike Thompson (D-Calif.) and Ben Ray Luján (D-N.M.) – decided to do something about it. Together, they introduced the Furthering Access to Coordinated Treatment for Seniors (FACTS) Act, legislation to break down silos in a patient’s continuum of care that allow medication mismanagement to fester unseen. To say this bill can save lives is not dramatic, it is a fact.

Roughly 80 percent of older Americans have at least one chronic condition, and more than three-fourths have at least two. That makes for many visits to the doctor’s office and the pharmacy counter – so you might be concerned to know that, under current law, communication is stymied between doctors and pharmacists in these two settings. 

For all the advances in electronic health records and interoperability that is supposed to allow for better coordination between a Medicare beneficiary’s primary care provider and the various specialists they may see, there is no process for Medicare to share information about hospitalizations or physician office visits with a Part D prescription drug plan. In the year 2017, this is not something we can accept.

This disparity means Part D Plans and pharmacists risk being totally in the dark about a patient’s past hospitalization or other complications related to improper use of their medication, and therefore won’t be able to proactively tailor their medication counseling accordingly — a reality with deadly consequences.

By opening the lines of communication, as this bill does, providers will have a better opportunity to recognize those most at risk of medication nonadherence and intervene before it is too late. Importantly, the legislation does this without making changes to existing privacy laws designed to protect patient confidentiality.

Lawmakers are already recognizing that this policy is a win for consumers. That is why a near exact copy of the House bill was unanimously added as an amendment to the Senate Finance Committee-passed CHRONIC Care Act earlier this year.

The Congressional Budget Office cost estimate for that amendment? Zero. Although a more dynamic view of the policy could show savings to taxpayers, given the legislation’s potential to put a crack in this $300 billion driver of annual health costs.

The bill is not a panacea, but it is a start. Now, it is time for Washington to do the right thing by getting it passed and signed into law.

Congress needs a win on health care and patients grappling with the consequences of medication nonadherence need a lifeline. The FACTS Act can offer both.

Sloane Salzburg, M.S., is the executive director of Prescriptions for a Healthy America, a medication adherence partnership that brings together leading patient, physician and health care industry leaders to support solutions that will reduce health care costs and improve quality of life for patients.

The views expressed by contributors are their own and not the views of The Hill.