AMERICAS AGENDA HEALTHCARE EDUCATION FUND
1025 Connecticut Avenue NW 907, Washington, DC 20036 www.americasagenda.org

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Organizations Filed Purposes: To undertake policy development, public education, leadership training, research and analysis with regard to public policy to achieve affordable high quality health care for all Americans.

Part III Program Service Accomplishments:In 2019, the America's Agenda Healthcare Education Fund (AAHEF or the Fund) continued our brisk pace of educational, research, analysis, and policy development program activities to advance of our mission of making access to high quality health care affordable for all Americans. The Funds principal 2019 program actiities focused in the following three areas:1.Redesign of Public Sector Healthcare Delivery Beginning in 2018 and continuing through 2019, the Fund focused its work on public employees health benefits and care delivery design through its contributions to the Governors Taskforce on Health Benefits Quality and Value in the State of New Jersey. As a result of New Jersey Governor Murphys appointment the Funds Managing Director Mark Blums as a member of the Task Force, AAHEF was able to contribute significantly to shaping key features of the Task Forces blueprint for healthcare delivery and payment system redesign for a public employee health care plan that provides health benefits to approximately 750,000 state, local government, and public school employees, and their dependents. The Funds principle contribution in the areas of health benefits and provider network design were reflected to a significant degree in the Task Forces 2018 Interim Report, which was applied as a framework for a 2019 Statewide Request for Proposals (RFP) to commercial health plans to operationalize the Task Forces recommendations in the following areas: Support for innovation to improve health outcomes and costs; Improvment contractor accountability; Prioritization of quality; Ensurance of access to care; and, Use of data and analytics to improve outcomes and reduce costs. In the course of 2019, the Task Force changed its focus from the shorter term goal of issuing an innovative 2019 health plan RFP to creating a long-term strategic plan for State of New Jersey public employee health benfits, focusing on the areas above from a longer term perspective that can serve as a template, potentially, for New Jersey statewide public and private sector care delivery transformation. The creation of consensus on a long-term, statewide strategic plan of this magnitude among diverse stakeholder members of the Task Force has proven challenging. Progress had been made. But by the end of 2019, a final conesus was not reached in full on significant elements of the long-term Final Task Force Report. The work continues in 2020.2.Structuring Dynamically Competitive PBM Marketplaces to Reduce Cost of Prescription MedicinesDuring 2016 and 2017, AAHEF had focused on developing its hypothesis for how creation of dynamic competition in the PBM marketplace could capture significant savings to State employee health plans purchasers of prescription drugs. The hypothesis was tested successfully in New jersey in 2017 with capture, with NJ adoption of an AAHEF-designed PBM reverse auction strategy, State prescription drug savings projected at $1.6 billlion over a 3-year period, and realized savings in 2018 at 25%.. In 2019, the State of New Jersey (following a subsequent Fund analysis of prospective savings that would result from an accelerated conduct of a second PBM reverse auction) decided to implement a second PBM reverse auction only two years after the first one. The result of New Jerseys second PBM reverse auction, conducted in early 2019: was extended prescription drug savings at an average rate of $500 million per year for a projected cumulative savings $2.5 billion over 5 years Information about these back-to-back successes in implementing the AAHEF-designed strategy have generated inquiries to the Fund from a growing number of State leaders and public sector union representatives from across the country seeking information and education about how a similar strategy could be designed for their jurisdictions. In response, the AAHEFs Labor & Employer Healthcare Transforation Project (LEHTP), has developed a battery of explanatory materials and presented them in policy briefings on a non-partisan basis to senior members of state governors staffs, state legislators and their staffs, and public sector employee representatives in California, Pennsylvania, New Hampshire, Maryland, Illinois, Washington State, among others. The materials and presentations comprising the new LEHTP policy module focus on common-sense principals framed non-ideologically as common-ground, bipartisan policy solutions to create dynamically competitive PBM marketplaces that will drive significant savings to self-funded State health plans and their beneficiaries -- and ultimately, to taxpayers -- without requiring cuts in prescription benefits for public employees. Legislation was drafted in California. Based on state interest in reduction of prescriptioin drug costs and the volume of requests for information coming into the Fund from other states, we expect to see drafting of more legislation to adopt variations of the AAHEFs NJ dynamically competitive PBM market strategy in other states in 2020 and beyond.3. Public Education - During the course of 2019, AAHEF has accelerated its public eduational activities regarding our work in high-value care delivery design and the lessons learned from the implementation of AAHEF-articulated care delivery design principles in both public and private sector settings. The Fund continues its traditional public educational work through ongoing direct training and education of employers and labor unions in the Funds Labor and Employer Healthcare Transformation Project (LEHTP), but the Fund is amplifying its reach through through intensified social and earned media activities. As an additional example of ongoing the LEHTP activities during 2019, the Fund presented seminars on Fund-developed strategies for reducing self-funded health plan prescription drug costs attended (and rated highly) by several hundred multi-employer health plan trustees and administrators at the 2019 Annual Conferene of the International Foundation of of Employer Benefit Plans in San Diego. The following examples illustrate the educational outreach that AAHEF is achieving through its accelerated 2019 earned and social media activities:Commonwealth Fund: In Focus: How Unions Act as a Force for Change in Health Care Delivery and Payment AAHEF worked extensively with the editors of the Commonwealth Fund online magazine to develop a quarterly publication in Spring 2019 devoted exclusively to the innovative and leading-edge work of Labor unions and employer partners, in general, and of AAHEF, in particular, at the forefront of US health care delivery transformation. Managed Care magazine: Reverse Auction Grows PBM Savings in the Garden State: In New Jersey, a race to the bottom saves a billion The story in Managed Cares July/August2019 Innovation Edition discusses the New Jerseys savings experience in implementing AAHEFs strategy for capturing billions of dollars in prescription drug savings and the Funds theory of prescription benefit market restructuring that guided the initiative. Modern Health magazine: Labor Unions Strike Back at Rising Heath Costs - This July 20, 2019 cover article in features examples of the AAHEF high value primary care delivery design and state prescription drug market restructuring strategy for capture of prescription drug savings.Podcasts: AAHEFs health care cost-reduction work in both of the above areas -- high value care delivery redesign and state prescription drug market restructuring -- were the focus of interviews with AAHEF General Manager Mark Blum in the following 2019 podcasts:Shape Shifters podcast: Ep #251: What If Employees Owned Their Employer-based Plans? with Mark Blum (Jan. 28, 2019)The Dose podcast: How Unions Can Transform the Way Americans Get Care (May 17, 2019)Relentless Health Value podcast: EP248: United We Could Definitely Stand Agains Rising Health Care Costs, with Mark Blum from Americas Agenda (Oct. 24, 2019) As an integral part of the AAHEFs expansion of online public educational outreach, the Fund has redesigned the Americas Agenda website, www.americasagenda.org. The newly designed site became operational in 2019 as an important component of the Funds initiative to broaden its public educational outreach online and through multiple social media channels.

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