William Pierce, senior vice president of APCO Worldwide, joined in 2005. Mr. Pierce specializes in providing strategic advice and counsel, tactical execution and representation to a wide range of clients facing challenging circumstances as well as great opportunity. He helps clients develop strategies and tactics that combine media relations, policy, advocacy and alliances in campaigns to achieve definable objectives. Areas of expertise include health care reform, policy development, the FDA regulatory process, Medicare, Medicaid and SCHIP policy, public health, Bio-terrorism, the CDC and NIH. His work includes media relations, policy development, issues advocacy, message development, coalition and third party development and management and crisis communications.
Previous to joining APCO Worldwide, Bill served as the Deputy Assistant Secretary for Public Affairs at the Department of Health and Human Services (HHS) beginning in 2001. At HHS Bill had the unique opportunity to be at the forefront of some of the country’s most challenging and unexpected health policy and public health debates. Beginning with President Bush’s 2001 announcement regarding a new stem cell policy, the 9/11 and anthrax attacks, through the Medicare debate, passage and implementation, to the flu shortage and the debate over Medicaid reform, Bill stood at the frontlines as the spokesman for HHS and one of HHS’ key public affairs advisors.
Pierce received his appointment to the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Public Affairs (ASPA) as the Deputy Assistant Secretary for Public Affairs in June 2001 after serving for four and one-half years with the Blue Cross and Blue Shield Association (BCBSA) as Director, Public Affairs. Previous to working at BCBSA he served three and one half years as the Press Secretary for Congressman Bill Thomas (R-CA). Prior to joining Rep. Thomas’ staff, Pierce was Press Secretary for then Rep. (now Senator) Olympia Snowe (R-ME). Before working on the Hill, Bill was Director of Communications for the National Taxpayers Union, an Account Executive for Hill & Knowlton and a Research Associate with Government Research Corporation. He began his career in Washington as a Research Analyst for the National Republican Senatorial Committee.
At HHS, Bill was responsible for managing the press, speechwriting and Freedom of Information Offices. His duties included helping to develop strategic and tactical media strategies and messages. He was a spokesman for HHS and HHS Secretaries Tommy G. Thompson and Michael O. Leavitt. Bill was the ASPA liaison with several key HHS agencies including CMS, FDA, NIH, and CDC. He was also the ASPA representative on the Secretary’s Privacy Council, HIPAA Council, Global Health Policy Core Group and other ad hoc policy committees within the Office of the Secretary. Bill has been an official member of several US delegations to World Health Organization meetings and taken part in international trips including a 5-nation visit to Africa. Bill also was public affairs representative on two Better Benefits Tours in the summer of 2002 and 2003, four city tours promoting the need for better benefits in Medicare that included then FDA Commissioner Mark B. McClellan, M.D., Ph.D., Surgeon General Richard Carmona, M.D., CDC Director, Julie Gerberding, M.D. and NIH Director Elias Zerhouni, M.D. During 2004, Bill acted as the temporary Director of the Public Affairs Office at the Centers for Medicare and Medicaid Services.
At BCBSA, Bill was responsible for developing and implementing the Association’s strategic public affairs campaign for all advocacy and policy efforts. This included issue advocacy advertising campaigns, public opinion surveys and message development. Bill was the spokesman for the Washington office of BCBSA as well as a spokesperson for the entire Association.
In Rep. Thomas’ office, Pierce was his chief spokesman and press contact for Thomas in his role as Chairman of the Health Subcommittee of the Ways and Means Committee and Chairman of the House Oversight Committee. In Rep. Snowe’s office Bill was also the speechwriter.
Since 1988 Bill has attended all Republican national nominating conventions acting in various capacities. In 2008, Bill volunteered in the convention communications operations, in 2000 attended in his capacity as Director of Public Affairs for BCBSA. He has staffed Members of Congress in 1992 and 1996, worked with the National Young Republicans in 1996 and volunteered with the 1988 George Bush for President campaign. Bill has contributed chapters to the books, Communication in a Healthcare Crisis and Risky Business? PAC Decision-making in Congressional Elections.
Previous to coming to Capitol Hill Bill worked in the private sector focusing on legislative and political analysis developing experience in budget, tax, energy and defense policy as well as conducting political research.
Bill earned his Bachelors of Arts degree in Political Science and English and a Master’s degree in International Relations from the University of Pittsburgh. In 1998, he also earned the designation of Professional from the Academy for Healthcare Management. In 2000, Bill became a founding member of the George Mason University Mercatus Center’s Advisory Council for Capitol Hill Programs – a center providing educational programming on a wide
variety of issues to Capitol Hill staff and Members of Congress. Bill has been a volunteer mentor with the Hoop Dreams Foundation; a mentoring program for college-bound Washington, D.C., inner-city students.
• Create health exchanges: Similar to the Federal Employees Health Benefit Plan (FEHBP) and the Medicare Advantage and Prescription Drug Benefit, divide the country up into 10 regions. That way you could reflect local needs and would avoid the one-size-fits-all problem. Insurers could offer plans in one, more than one or all regions as is allowed in the FEHBP program and they would compete on price and quality. Open season and marketing standards could be enforced by HHS working with the states.
• Change how we pay for care: Paying for care based on individual procedures promotes higher utilization. Everything has become a specific cost center. We must move away from this system of payment. What we need in its place is a system that pays for care based on a continuum of care. Doctors and hospitals would get a single payment to treat a patient, and that payment would cover whatever was needed to appropriately treat the patient. Payments would vary based on whether the illness was acute of chronic. Physicians would also receive payments to keep patients healthy. If the physician or hospital was able to treat the patient for less than the payments they could keep some percentage of the payment and return the remainder to the insurer (private or government). There are already several good ideas out there that would take us down this path—accountable care organizations and community health teams to name two.
• Pay for quality/value: Today, providers of health care are paid per episode or visit regardless of the outcome of the event. We need to move toward a system that pays physicians and others based on the quality of the service provided and the efficiency of it. This means we’ll have to invest in comparative effectiveness research (CER). CER is not cost focused research and should not be used to determine what to cover based on cost. Sometimes the most expensive treatment is best, and sometimes not.
• HIT: An HIT system for sharing information between physicians and other providers is essential to a modern health care system in order to reduce duplicative tests and avoid errors. Patients also need better access to information about treatments. That way everyone would know what the standard of care was. A well developed HIT system would also be necessary in order to know who was providing the standard of care and then to pay for it.
• Phase in an individual mandate: Whatever you call it, if you are going to decouple health insurance from employers and reform the insurance marketplace, an individual mandate is necessary. Phase it in over the same time period the employer tax deduction is phased out. This way the tax revenue to pay for credits and deductions would rise with the mandate.
• Insurance market reforms: There is already uniform agreement that we need to make changes to such things as pre-existing clauses and rescissions, limit premium variation, administrative simplification including standardized electronic claims processing and the like. The key to implementing these is that we need near universal coverage for them to work without increasing premiums.
• Medical malpractice reform: There is no doubt we need reform in this area. While it is not as big a cost drive as many claim, the system is not just. Some get great rewards when harm is done, some do not, and some get great rewards when no harm is done. Medical courts are an interesting idea that should be explored as is arbitration. Both would be more equitable than our current system
• Employer wellness: Create a tax credit for employers who provide their employees with a wellness program. Minimum eligibility standards would be necessary, but such standards have already begun to emerge. Employees spend at least eight hours a day working so why not use that time to encourage health and wellness. While still in its infancy, there are many examples of companies who offer programs that reduce their health care costs, while reducing absenteeism and boosting productivity.
Medicare, Medicaid and SCHIP could all be folded into this system either entirely or simply as programs, but if done right there would be no need for individual systems to serve different demographic or income groups. The funding for these programs would follow them into this new system, but due to efficiencies costs should be more stable and predictable.
These ideas are not meant to be all-inclusive and clearly much needs to be worked out. But these ideas would distinguish Republicans from Democrats and set the stage for a real debate over the best direction to move the country and our health care system.
William Pierce is Senior Vice President for APCO Worldwide, Inc.
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