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Bloomberg Nursing professor Dr. Arlene Bierman, an authority on care for older adults with chronic illness, is taking her expertise to Congress. 

Bierman has been accepted into the Atlantic Philanthropies Health and Aging Policy Fellows Program. The prestigious year-long opportunity is designed to equip experts with policy experience and networking connections while helping the United States government develop and implement evidence-based health policies.

As a Fellow, Bierman is working in the United States Department of Health and Human Services (HHS) Office of the Assistant Secretary of Health (OASH), collaborating with the National Institute of Aging and collaborating with the Center for Medicare and Medicaid Innovation. 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.

Writer Kendra Hunter spoke with Professor Bierman, who specializes on the health of socio-economically disadvantaged older adults and the inequities in health care that they experience, about this appointment.

What is the Health and Aging Policy Fellows Program?
We can’t deliver effective care to older adults without large-scale health system transformation and this program, established in 2008, was created to address this growing concern. An estimated 71 million Americans will be 65 and older by 2030, and there is urgency to develop and implement innovative models to care for this population, many of whom will have complex health problems and rely heavily on the health care system. 

Equally important is the need to promote and foster active aging and reduce the burden of illness among aging populations. The Fellows Program is integrated with the American Political Science Association (APSA) Congressional Fellowship Program – the oldest and most prestigious congressional fellowship in the U.S. The opportunity to participate with an interdisciplinary group of peers on tackling the critical health and aging policy issues currently facing the U.S., and by extension Canada, is a great honour. 

What are you working on for the duration of your Fellow Program?
I’m at the start of a six-month sabbatical to the U.S. to work more intensely on my Fellowship projects and placements. At the HHS Office of the Assistant Secretary of Health (OASH), I am working on developing strategies to achieve the objective of the Multiple Chronic Condition initiative. My focus is on the role of health information technology in improving quality and outcomes of care for people with multiple chronic conditions. This includes patient engagement, quality improvement, clinical decision making, and population health management. 

Collaborating with the Center for Medicare and Medicaid Innovation (CMMI), I am involved in the implementation and evaluation of the Comprehensive Primary Care Initiative, a multi-payer demonstration of a medical home model in 500 primary practices in seven states. In the office of Congressman Jim McDermott, I have the opportunity to learn more about the policy process.

What have been a few of the highlights so far?
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. The level of exposure has been phenomenal and provided me with new insights on how to effectively translate research to policy in order to improve both population health and health care delivery.

The program affords Fellows the opportunity to participate a week-long Canadian Parliamentary Exchange to get a cross-border perspective on a wide range of policy issues. The exchange provides a better understanding the differences in the policy process and governance between the two countries. We met with leaders from each political party including Stéphane Dion, Thomas Mulcair and John Baird, and received valuable one-on-one interactions with the people shaping Canada’s health care policies. This experience on Parliament Hill and meeting the senior-level officials with my American colleagues has been one of the highlights of the year. 

Can Canada learn from the U.S.?
Canada can learn a great deal from the U.S. and the U.S. can learn a great deal from Canada. While Canada has universal access to health care, and the U.S. has yet to achieve universal coverage both countries face similar challenges in the need to improve quality, value and efficiency of care. Both countries need to redesign their health systems to improve chronic disease prevention and management and to care for the growing number of people with multiple chronic conditions. We can accelerate learning from drawing on the respective experiences in each country to work towards these goals. There is also opportunity for scientific exchange on the methods of implementation science, performance measurement, and quality improvement.

It’s a very interesting time in U.S. health care and the potential for cross-border learning and knowledge exchange between the U.S. and Canada has never been greater. 

Kendra Hunter is a writer with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto.