ARLINGTON, Va. — In the decade since Steve Anderson became president and chief executive officer of the National Association of Chain Drug Stores, the organization has solidified its position as the preeminent voice for retail pharmacy and established itself as the indispensable network for interaction among those within the sector, and communication between the industry and other health care stakeholders.
By working at the outset with the NACDS board to develop a tightly focused group of guiding principles and strictly adhering to them, Anderson has been able to raise the profile of community pharmacy in the nation’s capital and beyond, and, in the process, increase the profession’s standing and impact.
“We established a strategic plan at the start that emphasized three key disciplines — government affairs, communications and member services,” says Anderson. “It sort of functions like the United States Constitution — it shouldn’t change too much in terms of the strategy; what changes constantly are our tactics.”
For the ability he has consistently demonstrated in leading the association and its members through diverse contingencies while never losing sight of NACDS’ broader objectives, the editors of Chain Drug Review have named Anderson the winner of the publication’s Industry Leadership Award.
When Anderson, a seasoned leader who for many years headed the National Restaurant Association and the American Frozen Food Institute, arrived at NACDS in 2007, the association, while still widely respected, had to some extent lost its bearings and lacked sufficient discipline, which resulted in pressure on its financial underpinnings. Anderson, who is sometimes referred to as “Mr. Fix It,” methodically went about righting the ship.
“You don’t move too quickly or too brashly,” he recalls, “and you listen to a lot of people. You have to figure out where the various constituencies are for each cause and effort. So you’re not going in there saying, ‘My way or the highway, this is the only way we’re going to do it.’ ”
“You need to understand the history, legacy and culture of an association — and they all have them, and that’s what I really love about the association work — but you also want to send a powerful message that some activities have to change because the board doesn’t think the place is running as well as it should or there aren’t enough public policy victories. That was the situation at NACDS.”
Throughout his 36-year career, Anderson has always made it a rule to follow the lead of the board and its chairman. Associations exist to serve their membership, he insists, not the other way around.
“From the beginning I worked very closely with the NACDS board of directors,” he says, adding that, at between 20 and 30 members, the group is small enough to ensure close interaction and involvement. “I kept them in the loop in terms of my ideas and didn’t implement anything unless I had board backing, and things have worked out very well.
“I’m very blessed from the standpoint that I’ve always had great people who are partners in leading NACDS, both members and staff. I view myself as part of the orchestra. We have a very diverse membership at NACDS. It’s my job to coordinate all those pieces of the orchestra and lead them in playing off the same sheet music, with maximum harmony and effectiveness.”
Among those people are the 72 individuals who comprise the NACDS staff. Anderson blended existing employees and newcomers to create a highly efficient organization that knows how to get results.
“There were some terrific staff members who were already here,” he recalls, “but NACDS had some pretty severe challenges at the time of my arrival, so we had to make some significant changes. We had some really talented people who wanted to come and work for us, not only initially but over the course of the last 10 years. We’re really hitting on all cylinders right now.
“As we go into this new environment with the 115th Congress, President Trump and the new administration, we’re going to need all the resources we can get, because the issues that Washington is going to be dealing with are considerably different than they would have been if we had been working with President Hillary Clinton. That changes the whole dynamic.”
NACDS’ clearly defined mission and discipline in carrying it out will serve members well in the current political environment. Anderson and his colleagues can be counted on to stay on message, driving home the value and latent potential of community pharmacy.
“One of the problems that NACDS had when I got here was a lack of focus and the establishment of priorities. Probably the most significant thing we did in conjunction with the board was to narrow down our priorities to concentrate on what we really needed to do, what really impacted our membership.
“Our forte is pharmacy issues, which are extraordinarily complicated, and I was pleased to discover that we had some really great people who understood pharmacy law and pharmacy policy better than anybody in the country. So we had a built-in infrastructure right there to address these issues.
“And we created a laser-like focus so we became more powerful on those issues. Prior to that, our beam of light was pretty diffuse, and not as strong and effective as we needed to be.”
The impact NACDS now routinely has on public policy is perhaps best illustrated by its involvement in the debate over the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. While careful not to endorse or oppose the controversial legislation as a whole, the association was relentless in its efforts to promote the inclusion of pro-patient, pro-pharmacy provisions in the law.
As enacted, the ACA advanced the cause of improving patient access to medication therapy management; gave pharmacies a conditional exemption from the accreditation requirement for durable medical equipment; reduced the substantial cuts in Medicaid payments for filling prescription medications that were mandated by the Deficit Reduction Act of 2005; took steps to close the “doughnut hole” in the Medicare Part D program; and expanded Medicaid coverage to millions of uninsured Americans.
Another strength NACDS has developed under Anderson is the ability to tell its membership — which is comprised of mass merchants and supermarkets that operate pharmacies as well as chain drug stores — exactly what such public policy victories mean for the industry in financial terms.
“The great thing about NACDS is that we quantify almost every public policy issue,” explains Anderson. “We have a staff that’s really terrific, so we know the cost of everything we do and how much we save the industry as a result.”
The most striking example is the federal lawsuit the association filed to block the Medicaid cuts that were partially alleviated in the ACA. Filed in conjunction with the National Community Pharmacists Association, the legal action ultimately mitigated the cuts that, according to estimates, could have forced the closure of 20% of all pharmacies — approximately 11,000 stores at the time.
“Our members understand the value equation,” Anderson notes. “There are a lot of associations across a wide range of industries that deal with issues in a nebulous way, saying we’re helping you out, but it’s kind of a touchy-feely approach as opposed to saying here’s how many dollars we’ve saved because of our work on this particular issue.”
Over and above the specific policy goals NACDS achieved in the ACA debate, the legislative process created an opportunity for Anderson and his colleagues to shine a light on community pharmacy. With President Obama, members of Congress and other policy makers focused on health care, the association drove home the contributions that members of the profession make to the well-being of patents every day, and their ability to help contain overall health care costs.
Creating a higher profile for retail pharmacy among payers in the private sector as well as policy makers is a long-term project that remains at the top of NACDS’ priority list. Anderson is convinced that the more people understand about the work of community pharmacists and acknowledge them as the face of neighborhood health care, the more clout the profession will have in the coming showdown over the fate of the ACA.
“The debate in Washington is going to be health care focused in a lot of different areas,” Anderson says. “You obviously have some turnover in the Congress every two years, but when you bring a new administration in, the overall policy is different. President-elect Trump ran on a platform of repealing and replacing of the Affordable Care Act. We don’t know any specifics about what he wants to do going forward, but we’ll deal with the situation as it arises.”
The NACDS RxImpact grassroots advocacy program will be an important tool in protecting and advancing the industry’s interests in the upcoming battles over health care policy.
“A lot of the members in the 115th Congress were there before and know our issues,” Anderson says. “We’ve done a terrific job with RxImpact Day on Capitol Hill, which brings industry leaders, pharmacists and pharmacy students to Washington to meet with members of Congress and staff members. We also have pharmacy tours in the stores, which are extraordinarily effective.
“It’s really interesting. When you go into a member of Congress’ office, it’s almost a continuation of a discussion, not just the one we had last year, but over several years or the one we started when they were visiting one of our member’s stores. They know our issues. We’ve done a really great job of building bipartisan support for issues like medication therapy management and provider status.
“NACDS is in a stronger position — our policy shop, our communications shop, our member services shop and our balance sheet — than we’ve ever been. We need a strong association to deal with all the changes that we’re going to see with the new administration.”
The days ahead — when, less than a decade after they were enacted, the nation may well reverse course on the most sweeping changes in health care policy since President Johnson’s Great Society of the mid-1960s — will require thoughtful, effective leadership. NACDS and its members are fortunate to have as committed, knowledgeable and articulate a leader as Anderson to represent their interests and those of the patients they serve.