Wound Care Stakeholders

The Association for the Advancement of Wound Care and the Coalition of Wound Care Manufacturers had been approached by several organizations to organize a “wound care stakeholders” meeting. Prior to this, the wound care community had not collectively engaged in an effort to share resources or build a leadership infrastructure for change in the wound care policy arena. Increasingly, it is collective advocacy, not individual advocacy that is most effective in changing public policy. The initial meeting was set in tandem with the SAWC meeting in Baltimore, Md. in April 2002. The premise of the meeting was to invite physicians, clinical, provider and manufacturer organizations who have an interest in wound care to identify clinical, legislative and/or regulatory issues of importance to their organizations. After these issues were discussed, if there was common interest, a strategic plan would be developed. This was the first time that such a broad base of health care professionals had an opportunity to meet and sit at the table to discuss issues of mutual interest.

AAWC and CWCM hosted this meeting and only served as catalysts. Every organization/association/company had an opportunity to place items on the agenda. There were strong assurances that there were no hidden agendas and that candor and cooperation would be the primary goals of the discussion. There was a professional facilitator to ensure that all views were addressed. Representatives from approximately 18 physician, clinical, provider, manufacturer and patient organizations voiced their concerns about wound care in their individual settings in the areas of access and quality, adequate reimbursement, and education. Specifically:
· Access and Quality: To produce and deliver the highest quality (i.e., efficacy) of care. However, with today’s fiscal constraints, and with Medicare coverage policies and HCPCS coding severely impacting the introduction of new technology, patients are often denied access to the most clinically effective wound care treatments which are usually also more cost effective.
· Reimbursement: To decrease the number of reimbursement hurdles which may ultimately hinder the development of new therapies and treatments.
· Education: To promote basic education about all different types of wounds (ischemic, vascular, pressure, diabetic, etc.) and how to address each to the entire health care delivery system and develop a wound specialty program within medical education.

Some of the organizations in attendance were:
American Academy of Dermatology association (AAD)
American Academy of Physical Medicine and Rehabilitation
American Academy of Wound Management (AAWM)
American Association for Vascular Surgery (AAVS)
American College of Surgeons (ACS)
American Diabetes Association (ADA)
American Physical Therapy Association (APTA)
American Podiatric Medical Association (APMA)
Association for the Advancement of Wound Care (AAWC)
Coalition of Wound Care Manufacturers (CWCM)
3M Health Care
Coloplast Corporation
ConvaTec
Hill-Rom Company
Hollister, Inc.
Johnson & Johnson Wound Management
Smith & Nephew
National Association for the Support of Long Term Care (NASL)
Undersea and Hyperbaric Medical Society
Wound Ostomy Continence Nurses Society (WOCN)

The following topics were discussed in detail:
Compression therapy
Wound Care Coverage and Reimbursement
Obtaining Medicare Part B Coverage for Certain Items of Complex Medical
Equipment in Nursing
Electrical Stimulation (E-Stim)

All participants agreed on the importance of collaboration in order to effect policy changes in wound care. Developing an organized and sustained information clearinghouse as well as the opportunity to work together on individual issues will build the foundation for a successful alliance. Participants discussed issues regarding the creation of an alliance, and decided to learn more about each organization present and their interests prior to forming an alliance. They expressed an interest in meeting again but agreed that forming an alliance at that time would be premature. Since lobbying efforts now rely almost entirely on the momentum of an alliance, stakeholders organization executives, as well as their staff, need to be involved and committed to such an effort. The report of the first meeting was distributed to all in attendance so that it could be shared within each stakeholder group and used to determine interest in becoming an alliance. At the next informal meeting of stakeholders, participants will have the opportunity to:
· Invite other organizations who may have an interest in wound care
· Enlist support for any ongoing wound care initiatives
· Discuss updates on above issues since initial meeting
· Identify a list of additional common issues that they can all endorse/support
· Determine whether a formal alliance should be formed, and if so:
o Seek approval from internal association executives
o Identify alliance name, infrastructure and dues structure
o Appoint a member of each organization as the official alliance representative
o Define the alliance’s mission and purpose
o Develop an evidence subcommittee to find and review data that will demand necessary changes