Accepted to the prestigious Health and Aging Policy Fellows Program, Bloomberg Nursing Associate Professor, Dr. Arlene Bierman has taken her research expertise to Congress. As a Fellow, Dr. Bierman is working in the HHS Office of the Assistant Secretary of Health where she is interfacing with the National Institute of Aging on implementation of the multiple chronic condition strategy and collaborating with the Center for Medicare and Medicaid Innovation on evaluation of integrated care demonstration projects. She is also working in the office of Congressman Jim McDermott, ranking member of the House Ways and Means Health Subcommittee, on issues related to Medicare reform.
“This has been an experience of a lifetime and will have a huge impact on my research going forward,” says Dr. Bierman, who is cross-appointed to U of T’s Institute of Health Policy, Management and Evaluation, the Division of Geriatrics in the Faculty of Medicine, and the Dalla Lana School of Public Health. “As part of this program, I’ve had the opportunity to meet with top officials, sit in on Congressional meetings and learn the intricacies of both the U.S. and Canadian legislative process. This exposure has provided new insights on how to effectively translate research to policy in order to improve both population health and health care delivery.”
The Health and Aging Policy Fellows Program, established in 2008, is integrated with the American Political Science Association (APSA) Congressional Fellowship Program – the oldest and most prestigious congressional fellowship in the U.S. Created to address the critical health and ageing policy issues currently facing the U.S., and by extension Canada, the highly competitive program brings together the sharpest minds in health care of older adults. This year-long opportunity, which can be extended to two years, is designed to equip these experts with policy experience, projects and networking connections that will help develop and implement health policies through their contributions. An estimated 20% of the American population will be 65 and older by 2030, and now is the time to begin building solutions for a group who will have complex health problems and heavy users of the health care system.
In her role with the Office of the Assistant Secretary for Health, Dr. Bierman is working on implementation of the Multiple Chronic Condition Strategy, which involves all federal health agencies. Her work is specifically addressing the objective of enhancing the role of health information technology and electronic health records to support providers and patients in improving quality and outcomes of care. At the Center for Medicare and Medicaid Innovation she is working on the evaluation of the Comprehensive Primary Care Initiative which is implementing a medical home model in 500 primary practices in seven states. She is learning methods of implementation and rapid cycle evaluation to support large scale health system innovation through spread of effective innovations.
“We can’t deliver effective care to older adults without innovation,” says Dr. Bierman, who is also a Senior Scientist in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital. “The Center for Medicare and Medicaid Innovation is supporting a number of large scale demonstration projects looking at ways to implement and evaluate innovative models of care to create a medical home and ultimately, a medical “neighbourhood”–that integrates and coordinating the care addressing the health care needs of an older population.”
Recognizing the importance of addressing Canadian politics and policy-making in health care, the program sends the Fellows on a week-long Canadian Parliamentary Exchange to get a cross-border perspective on a wide range of policy issues. “The access we were granted to Parliament Hill and the senior-level officials was phenomenal,” says Dr. Bierman. “The exchange provides a better understanding in differences in the policy process and governance between the two countries. We were able to hear the perspectives of all political parties as well as learn about current priorities in health policy.”
While Canada has more universal access to health care, both countries face similarities in the need to improve quality, value and efficiency of care . “It’s a very interesting time in U.S. health care and the potential for cross-border health care delivery and knowledge between the U.S. and Canada has never been greater as both countries need to redesign their health systems to support chronic disease prevention and management and meet the needs of aging populations,” she said. “Both countries have a lot to teach each other.”
Dr. Bierman will be taking a six month sabbatical, starting July 2013, to be able devote more time to fellowship activities. She looks forward to applying her learning to her future research.