March 2013 webinar congressional advocacy prep

MARCH 2013 WEBINAR

Three Part Series on Advocacy Issues in prep for our advocates.- Presented by Camille S. Bonta, MHS

Principal of Summit Health Care Consulting

Welcome!

Medicare Cost Sharing for Screening Colonoscopy

Part of Fight Colorectal Cancer’s Monthly Patient Webinar Series – Part 1

www.FightColorectalCancer.org877-427-2111

Fight Colorectal Cancer

1. Our speaker: Camille Bonta, MHS, Policy Expert

2. Archived webinars: Link.FightCRC.org/Webinars

3. Or call the Fight Colorectal Cancer Answer Line at 877-427-2111



Funding Research DirectlyLisa Dubow Fundhttp://fightcolorectalcancer.org/research/lisa-fund

http://fightcolorectalcancer.org/research/lisa-fund

Fight Colorectal CancerDisclaimer

The information and services provided by Fight Colorectal Cancer are for general informational purposes only.

The information and services are not intended to be substitutes for professional medical advice, diagnosis, or treatment.

If you are ill, or suspect that you are ill, see a doctor immediately. In an emergency, call 911 or go to the nearest emergency room.

Fight Colorectal Cancer never recommends or endorses any specific physicians, products or treatments for any condition.




Camille S. Bonta, MHS Principal of Summit Health Care Consulting


Preparing to Talk with Members of Congress about Cost Barriers to Colorectal Cancer Screening for Medicare Beneficiaries

Call-on Congress

March 18-20, 2013


• Current Medicare Law– Colorectal cancer screenings are free, including

screening colonoscopy.– However, if polyp is removed during

colonoscopy, Medicare beneficiary must pay coinsurance.

– February 20 Administration communication clarifies, under health reform law private insurers cannot impose cost sharing for screening colonoscopy when polyp is removed.

• Coinsurance liability persists for Medicare patients.


• Why Current Law Requires Correction– Cost sharing creates disincentive to screening.

• March 2012 study – During recent economic recession, insured Americans (age 50-64) reduced use of screening colonoscopy.

– Trends in decreased colorectal cancer incidence, but screening rates still lag behind the Healthy People 2020 goal of 70.5%.

• 1 in 3 Americans are not up-to-date with recommended screening.


• Key Messages

– Current Medicare policy is confusing to patients and health care providers.

– Coinsurance “gap” due to unintentional oversight in the law.


• Key Messages

– Screening colonoscopy is the most effective test for the prevention of colorectal cancer.

• Allows for the removal of potentially precancerous polyps during the procedure, making it a unique preventive service.

• Medicare pays roughly $600-$1,300 for screening colonoscopy (with anesthesia); $300,000 annually to treat an advanced case of colorectal cancer.


• Cost Sharing Definitions

– Deductible: Amount beneficiary has to pay out of pocket for expenses before Medicare will cover the remaining costs.

– Coinsurance: Set percentage the beneficiary must pay of the covered costs after the deductible has been reached.


• Colorectal Cancer Screening Coverage and Cost Sharing History

– 1998: Medicare coverage of screening colonoscopy for high-risk individuals.

– 2001: Medicare coverage of screening colonoscopy for average-risk individuals.



– 2006: Deficit Reduction Act waived Medicare beneficiary deductible for colorectal cancer screening.

• However, if a polyp was removed during screening colonoscopy, beneficiary was liable for the deductible.



– 2010: Affordable Care Act corrected previous law. Now deductible is always waived, even if a polyp is removed during a screening colonoscopy.



– 2010: Affordable Care Act waives coinsurance for colorectal cancer screenings.

• Colonoscopy, Sigmoidoscopy, FOBT

– But, Medicare beneficiary must still pay coinsurance if polyp is removed during screening colonoscopy.


• Fight Colorectal Cancer’s Request to Congress

– Congressional Action is Needed this Year to Correct Coinsurance Gap

• House and Senate legislation poised for introduction in March.

• Legislation same as 112th Congress - H.R. 4120, “Removing Barriers to Colorectal Cancer Screening Act.”


• Parting Words

– An effective advocate ties their personal story with key messages and facts.

– Colorectal cancer prevention has a history of bipartisan support.

– Despite claims, colorectal cancer screenings are not without cost sharing for all Medicare beneficiaries.

– Congress needs to take action this year.

Fight Colorectal CancerCONTACT US

Fight Colorectal Cancer1414 Prince Street, Suite 204

Alexandria, VA 22314(703) 548-1225

Toll-Free Answer Line: 1-877-427-2111www.FightColorectalCancer.org

Email us: [email protected]

http://www.fightcolorectalcancer.org/

Welcome!

Supporting Colorectal Cancer Research




1. Tonight’s speaker: Camille Bonta, MHS, Policy Expert




Fight Colorectal CancerDisclaimer

The information and services provided by Fight Colorectal Cancer are for general informational purposes only.









Preparing to Talk with Members of Congress about Funding for Colorectal Cancer Research

Call-on Congress

March 18-20, 2013


• Lawmakers can demonstrate their commitment to colorectal cancer research by:

– Providing increased funding for the DoD Peer Reviewed Cancer Research Program (PRCRP).

– Funding the National Cancer Institute (NCI).


• Key Messages

– Difficult budget environment lends urgency to grassroots advocacy.

– Millions invested in cancer research to date have led to great advances.

– Cancer incidence will nearly double by 2020.– 5-year survival rate for colorectal cancer is now

67 percent.– Now is not the time to pull back on federal

funding.

DoD Peer Reviewed Cancer Research Program

• Supports research into specific cancers, including colorectal cancer, with relevance to military service members.

• Program is one of several medical research programs under the Congressionally Directed Medical Research Programs (CDMRP).


– Innovative, high-reward research.– Supports early-career researchers and

clinicians.– Focused on delivering breakthroughs in

prevention, detection, and treatment of cancer.– Complements, not duplicates, research

conducted through the National Institutes of Health (NIH).


• Funding History

– Fiscal Year 2009 - $16 million– Fiscal Year 2010 - $15 million– Fiscal Year 2011 - $16 million– Fiscal Year 2012 - $12.8 million– Fiscal Year 2013 - Continuing Resolution– Fiscal Year 2014 - $16 million (Fight

Colorectal Cancer Request)


• Colorectal Cancer Funding History

– Colorectal cancer first included in the PRCRP in fiscal year 2010.

– Fiscal year 2010 – 472 applications; 101 for colorectal cancer research.

• Four colorectal cancer grants funded for total of just under $2 million.

– Fiscal year 2011 – 845 applications; 135 for colorectal cancer research.

• Four colorectal cancer grants funded for total of $1.3 million.


• Military Relevance– Colorectal cancer is one of the most common forms of

cancer among active duty military personnel.– Colorectal cancer screening rates low (58%) among

military personnel. – Service members are exposed to ionizing radiation in the

field, which increases risk of colorectal cancer.– PRCRP-supported research into non-invasive genetic

urine test for colorectal cancer.– PRCRP-supported research on genes associated with

ionizing radiation sensitivity and resistance.

National Cancer Institute

• National Cancer Institute

– One of 27 Institutes and Centers at the NIH.– Leads a national effort to eliminate the suffering

and death from cancer.

NIH Appropriations

National Cancer Institute• Funds critical colorectal cancer research.• Congressional support for cancer research

has contributed to the overall reduction in cancer incidence and mortality and an improved quality of life for survivors.

• Today’s progress in research and promising scientific opportunities require a sustained commitment from Congress.– The Cancer Genome Atlas is studying 20

different cancers, including CRC, which will lead to more targeted and personalized therapies.


• NIH Funding Supports Economic Growth– NIH spending in 2011

• Produced $62.13 billion in new economic activity.• 432,094 new jobs.

– $3.8 billion in funding for the Human Genome Project from 1988-2003 resulted in a return on investment of $141 in economic output for every $1 spent.


• Federal government spends through the NIH just over $5 billion on cancer research annually.

• Annual direct cost of cancer care is $158 billion.


• NIH Funding History– Fiscal Year 2011 - $30.388 billion– Fiscal Year 2012 - $30.623 billion– Fiscal Year 2013 – Continuing Resolution– Fiscal Year 2014 - $32.623 billion (Fight Colorectal Cancer

Request = 6.5% increase)

• NCI Funding History– Fiscal Year 2011 - $5.058 billion– Fiscal Year 2012 - $5.081 billion– Fiscal Year 2013 – Continuing Resolution– Fiscal Year 2014 - $5.349 (Fight Colorectal Cancer Request =

5.5% increase)


• Parting Words– An effective advocate ties their personal story

with key messages and facts.– Help lawmakers understand in human terms

the importance of DoD and NIH medical research.

– We are on the brink of losing the next generation of researchers.

– Cultivate new congressional cancer research champions.



Alexandria, VA 22314(703) 548-1225




Welcome!

Centers for Disease Control and Prevention

Colorectal Cancer Control Program




1. Tonight’s speaker: Camille Bonta, MHS, Policy Expert




Fight Colorectal CancerThe information and services provided by Fight Colorectal Cancer are for general informational purposes only.








Centers for Disease Control and PreventionColorectal Cancer Control Program

Preparing to Talk with Members of Congress about the CDC Colorectal Cancer Control Program

Call-on Congress March 18-20, 2013



• CRCCP Track Record Since 2009

– Screened 20,000+ Individuals– Identified 50 Cancers– Prevented 2,917 Potential Cancers by Polyp

Removal


• Key Messages

– Colorectal cancer screening saves lives.– Colorectal cancer screening saves costs.– The CRCCP should be a national program, not

just a program limited to 25 states and 4 tribal organizations.

– Fund the CRCCP at $70 million in fiscal year 2014.


• Recent Federal Funding History

– Fiscal Year 2010 - $44.53 million– Fiscal Year 2011 - $43.07 million– Fiscal Year 2012 - $43 million – Fiscal Year 2013 – Continuing Resolution


• Colorectal Cancer Screening Goals– Healthy People 2020 – 70.5% national

screening rate (adults age 50-75), which would represent 1,000 additional deaths prevented each year.

– CRCCP – 80% in CRCCP funded states by 2014.

– CRC screening rates increased 13% among adults from 2002 to 2010.

– Just under 60% the U.S. population (age 50+) is up-to-date with screening. 1 in 3 adults are not being screened.


• Colorectal Cancer Incidence and Mortality is Decreasing

– Incidence declining since 2000 – 3.2% per year in men and by 2.8% per year in women.

– Acceleration in the decline has been largely attributed to detection and removal of precancerous polyps.

– Mortality also decreasing – 3.1% per year in both men and women.


• More Americans have access to colorectal cancer screenings without cost sharing.

• Awareness remains low about why colorectal cancer screening at recommended intervals is important.

• CDC Program dedicates a majority of funds to education and outreach strategies.


• Fight Colorectal Cancer’s Request to Congress

– Fund the CRCCP at $70 million for fiscal year 2014.

• $27 million increase over fiscal year 2012.• Allows for nationwide implementation.


• Funding Challenges

– Difficult federal budget environment.• Unresolved fiscal year 2013 spending bill.• Sequestration.

– $350+ million less for CDC this year if sequestration occurs.

• Budget Control Act discretionary spending caps.– $1 trillion cut in discretionary spending 2012-2021.


• Parting Words

– An effective advocate ties their personal story with key messages and facts.

– Don’t be apologetic for asking your lawmaker to fund the CRCCP at $70 million.

– In this fiscal environment, if you ask for it, you have a better chance of getting it. If you don’t ask for it, you won’t. Or, worse, you may get less than what you have now.



Alexandria, VA 22314(703) 548-1225




Thank You!If you are unable to attend Call-on Congress this year, you can still participate in our advocacy efforts.

Join us on March 20th for our Congressional Call-in by calling 1-866-615-3375. You will be connected with your congressional members – take the opportunity to explain what it is we need Congress to do.

Documents

March 2013 webinar congressional advocacy prep