Blueprint for Action: 2016 ASHA Public Policy Agenda
The "Blueprint for Action—2016 Public Policy Agenda," developed by the 2015 Government Relations and Public Policy Board (GRPPB), presents ASHA's plan for legislative and regulatory advocacy and action for 2016. The "Blueprint for Action" is developed annually by the GRPPB and guides the advocacy efforts taken on by the Association and its members. The Blueprint includes the most pressing policy issues facing our members at the federal and state levels.
ASHA members were invited to provide input on the 2016 Blueprint. Input for the development of the 2016 Blueprint was provided through survey responses to a targeted group of ASHA members, including the Board of Directors, Advisory Councils, committees and boards, state association leaders, and Special Interest Groups. The survey was disseminated through e-mail, e-newsletters, social media, Headlines, and online Community and website postings, as well as outreach to Advisory Council members, committees, and boards. A total of 1,556 individual members and/or groups responded to the survey, including 1,370 speech-language pathologists (SLPs) and 144 audiologists. School-based members represented 31% of all respondents. More than 50,000 ASHA members were surveyed concerning 14 issue objectives.
Respondents were asked to read and rate the importance of each issue objective. For 12 issue objectives, respondents who provided a "Very Important" or "Somewhat Important" rating were asked to indicate which advocacy efforts relating to the issue objective were most important to them. Audiologists ranked, as the most important advocacy efforts, Medicare and Medicaid reimbursement, hearing health care, scope of practice, and demonstrating value and quality of services. SLPs ranked, as the most important advocacy efforts, funding and practice issues for school-based and early intervention services, Medicaid reimbursement, scope of practice, demonstrating value and quality services, and federal education.
Audiologists were also asked to rank six new and emerging trends in audiology. In order of importance from highest (i.e., Opt-out of Medicare) to lowest (i.e., Coverage of hearing aids, etc.), 105 audiologists indicated these preferences:
- Opt-out of Medicare
- Balance billing
- Bundling versus unbundling
- Greater regulatory oversight of big box retailers dispensing hearing aids
- Medicare benefit for partial coverage of hearing aids
- Coverage of hearing aids as a defined benefit in insurance plans
Respondents were asked whether ASHA should support reauthorization of the Children's Health Insurance Plan (CHIP), a federal-state program to provide health care coverage for children of low-to-moderate income families; 1,205 respondents said yes, and 97 said no. In April 2015, Congress reauthorized CHIP for 2 years, through September 30, 2017.
ASHA has made great progress toward achieving goals related to some of these public policy issues. For example, the sustainable growth rate (SGR) formula used for determining Medicare reimbursement for physicians and other health care providers was repealed and replaced by a system based on quality outcomes—the merit incentive payment system. The Steve Gleason Act pertaining to speech-generating devices (SGDs) passed, and major headway has been made on reauthorization legislation for the Elementary and Secondary Education Act and the Early Hearing Detection and Intervention Act.
ASHA must continue to educate members and policy makers on realistic changes to policy and practice necessary to compete in the changing health care landscape. Hence, issues identified in the Blueprint are those that—after careful analysis—have been deemed (a) feasible in the current state and federal political climate and (b) a good use of member resources. Some issues, such as paperwork and caseload reduction, are multipronged and will require policy efforts at the federal, state, and local levels. The success of other issues, such as Medicare direct access and/or limited license physician status, are problematic in the current political climate and within the changing health care industry, where the medical home and accountable care organizations are trendsetters moving away from direct access.
The Blueprint contains a number of issue objectives that promote the goal and outcomes sought in implementation of Strategic Objective 5: Increasing influence and demonstrated value of audiology and speech-language pathology services. For example, the Blueprint calls for increasing reimbursement, demonstrating value and quality of services, telepractice use and reimbursement, reversal of insurance denials, and equitable alternative payment models.
The Blueprint also contains seven foundational principles—commitment to ASHA members, ethics, client care and outcomes, evidence-base practice, diversity, and nondiscrimination—that provide a common thread throughout and underlie the issue objectives. Wording was added to one of the foundational principles, a commitment to client care and outcome, to include "committed to improve access to audiology and speech-language pathology services to address health and educational disparities in underserved and culturally diverse populations." This language was added to address the shortage of audiologists and SLPs in culturally diverse, underserved areas, such as areas served by the Indian Health Service.
Federal and State Levels
ASHA members can help move ASHA's advocacy efforts forward by serving as advocates for the professions. They can:
- share the Association's public policy agenda with peers to educate others on the advocacy efforts for 2016;
- review ASHA's legislative and regulatory advocacy efforts in the 2015–2016 ASHA Advocacy Report [PDF];
- participate in e-advocacy at the federal and state levels through ASHA's Take Action website;
- learn more about ASHA's Political Action Committee on ASHA's website;
- meet with members of Congress in their home districts or on Capitol Hill;
- work with state associations to advance state regulation and legislation favorable to members and consumers;
- follow ASHA Advocacy on social media.