Welcome to this week's edition of the The Partnership to Empower Physician-Led Care weekly newsletter, which includes news from our members, legislative and Administration updates, news clips, and studies about value-based care, primary care, and independent physicians.
HHS: (3/9) - The Office of Civil Rights at HHS announced a 45-day extension of the public comment period for the Notice of Proposed Rulemaking (NPRM) to modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. The deadline to submit public comments is now May 6, 2021. Notice of extension of comment period
HHS: (3/8) - The Biden Administration announced an effort to invest $250 million to encourage COVID-19 safety and vaccination among underserved populations. The HHS Office of Minority Health will offer the funding as health literacy grants to localities, who will partner with community-based organizations to reach racial and ethnic minority, rural and other vulnerable populations.
CMS: (3/8) - CMS announced the start date of the Kidney Care Choices (KCC) Model’s first Performance Year will be delayed to January 2022. Additional information will be shared on the model website at a later date.
CMS: (3/8) - CMS announced that the Primary Care First Model’s Seriously Ill Population component is currently under review, and will not begin on the previously announced April 1, 2021 start date. CMS will share additional information on the model webpage when it becomes available.
CMS: (3/5) - CMS announced it will extend the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track application deadline to May 11, 2021. The extension was made due to feedback from stakeholders regarding challenges faced preparing an application during COVID-19. Notice of funding opportunity
White House: (3/5) - President Biden and Vice President Harris announced the appointments of additional policy staff who will serve with the White House COVID Response Team, Domestic Climate Policy Office, Domestic Policy Council, and National Economic Council. Biographies of the appointees are listed in the press release.
CMS: (3/3) - CMS reported that more than 206,000 Americans signed up for health insurance plans during the first two weeks of the 2021 Marketplace SEP for consumers in HealthCare.gov States. The number of new plan selections from the start of the SEP opportunity on February 15 through February 28 represents an increase from 76,000 and 60,000 consumers signing up for health insurance during the same period in 2020 and 2019.
HHS: (3/3) - HHS Office of Inspector General (OIG) issued a report finding that 13 of the 155 sampled policies totaling $43,455 authorized by CMS were unallowable because they were made on behalf of enrollees who did not make their required premium payments.
CMS: (3/1) - CMS announced approximately $2.3 million in additional funding available to current Navigator grantees in Federally-facilitated Marketplace (FFM) states to support the outreach, education, and enrollment efforts around the 2021 Special Enrollment Period (SEP) that runs through May 15, 2021.
American Rescue Plan Act: (3/6) - The Senate passed with an amendment the American Rescue Plan Act of 2021 (H.R. 1319), which would provide for reconciliation pursuant to title II of S. Con. Res. 5 to provide additional relief to address the continued impact of COVID-19 on the economy, public health, state and local governments, individuals, and businesses. Notably, the Senate version of the bill would provide $8.5 billion in provider relief for rural providers. The bill now goes back to the House to be conferenced with the House version where the House would have to approve the changes before sending the legislation to the President for signature. Bill textAmendment Summary
Medicare Audiologist Access and Services Act: (3/3) - Rep. Rice (R-SC) and 25 bipartisan cosponsors introduced the Medicare Audiologist Access and Services Act of 2021 (H.R. 1587), which would provide certain coverage of audiologist services under the Medicare program.
Veterans Access to Direct Primary Care Act: (3/2) - Reps. Roy (R-TX), Cawthorn (R-NC), Budd (R-NC), Curtis (R-UT), and Sessions (R-TX) introduced the Veterans Access to Direct Primary Care (VADPC) Act (H.R. 1520), which would direct the Secretary of Veterans Affairs to establish a pilot program to provide veteran health savings accounts to allow veterans to receive primary care furnished under non-Department direct primary care service arrangements.
Senate HELP Committee: (3/2) - Senate HELP Committee Chair Murray (D-WA) announced HELP Subcommittee assignments. Sen. Sanders (I-VT) will serve as Chair and Sen. Collins (R-ME) will serve as Ranking Member of the Subcommittee on Primary Health and Retirement Security. Sen. Hickenlooper (D-CO) will serve as Chair and Sen. Braun (R-IN) will serve as Ranking Member of the Subcommittee on Employment and Workplace Safety. Sen. Casey (D-PA) will serve as Chair and Sen. Cassidy (R-LA) will serve as Ranking Member of the Subcommittee on Children and Families.
American PPE Supply Chain Integrity Act: (3/1) - Reps. McHenry (R-NC) and Pascrell (D-NJ) introduced the American PPE Supply Chain Integrity Act (H.R. 1466), which would require the purchase by the Federal Government of certain medical supplies and protection equipment from the United States.
Improving Health Insurance Affordability Act: (3/1) - Sen. Shaheen (D-NH) and 15 cosponsors introduced the Improving Health Insurance Affordability Act (S. 499), which would expand eligibility for the refundable credit for coverage under a qualified health plan, to improve cost-sharing subsidies under the Patient Protection and Affordable Care Act, and for other purposes.
Jackson Physician Search: (3/8) - Jackson Physician Search and MGMA announced an extended executive partnership to provide physicians and medical practices with resources and recruitment solutions to operate more efficiently and optimize the level of care to patients. Through the partnership, the groups will create resources to address the tight physician market, the competitive landscape, and physician recruitment and retention.
Medscape: (3/8) - Patients across the US face the challenge of where and how to receive the COVID vaccine, given not all physician practices have access to provide their patients with the vaccine. An MGMA survey found that 85 percent of independent physician practices have not been given any vaccine for their patients. Such physician practices are key to preventing more cases, more hospitalizations, and more deaths from the virus and should be prioritized in the vaccine distribution strategy.
State of Reform: (3/5) - The California Medical Association (CMA) announced its support of AB 80, which would conform California’s state tax code with federal law related to the Paycheck Protection Program (PPP) loans for multiple sectors including health care. According to CMA, the bill would help a number of small and independent medical practices so they can provide care to members of their communities without facing a large tax liability.
Apple Podcasts: (3/3) - On this episode of the Value-Based Care Insights podcast, Mollie Gelburd, Associate Director of Government Relations at MGMA, discussed anticipated policy changes in health care that will be introduced by the Biden Administration.
California Medical Association: (3/2) - The California Medical Association (CMA) extended its distribution of free personal protective equipment to California physicians. CMA distributed over 100 million pieces of PPE to physicians and medical groups between August and December 2020.
Harvard Business Review: (3/9) - Given financial difficulty providers have faced during the pandemic, the trend of consolidation in the health care system will likely continue, reducing competition and increasing prices. For example, a study found that acquisition of physician practices by hospitals in California were linked to higher prices for primary care and specialist services and to increases in premiums. This brief calls for Congress and regulators to take action to assess the impact of health care consolidation that adversely impacts payers and patients and prohibit or restrict the use of anticompetitive practices.
STAT: (3/9) - Many provider groups have been advocating for the need to include primary care providers in the vaccine rollout process, particularly when it comes to a successful campaign for mass vaccinations of seniors. However, many practices in California are struggling with accessing operational guidance on managing minimum order thresholds and following strict timelines set by the California Department of Public Health to responsibly handle the pre- and post-vaccination process. The article calls on public health officials to change the timeline for vaccine utilization to account for logistical challenges of vaccinating seniors, accumulate a centralized waitlist of patients interested in getting vaccinated, and give funding directly to providers for vaccine administration to reduce administrative burden for providers and better mobilize the vaccination effort.
PR Newswire:(3/9) - Cedar Gate Technologies, a value-based care performance management company, partnered with Privia Women’s Health to launch a value-based program to deliver high quality women’s care to patients across Texas. The program would create transparent pricing and improve quality of care through its prospective bundled payment program.
Medical Economics: (3/9) - To achieve value-based care and health equity, the health care workforce must be improved to ensure a high-value system that delivers equitable outcomes. Health care transformation must include scalable educational solutions and a focus on workforce competency and development to support the movement and drive success toward value-based care.
Revcycle Intelligence: (3/8) - The American Medical Association wrote a letter urging Congress to address “imminent threats” to physician practice viability in the COVID-19 relief bill being considered. Specifically, the AMA called on Congress to consider extending the moratorium of the two percent Medicare sequester which is set to expire on April 1 and the possibility of another four percent Medicare sequester triggered by the American Rescue Plan. The additional Medicare sequester could result in cuts to physician payment up to $36 billion.
Medpage Today: (3/8) - In its draft recommendations for possible inclusion in its June report to Congress, the Medicare Payment Advisory Commission (MedPAC) said CMS should reduce its portfolio of alternative payment models (APMs). MedPAC recommended the HHS Secretary implement a more coordinated portfolio of fewer APMs that reduce spending and improve quality.
Milbank Memorial Fund: (3/5) - For many patients, trust in the health system lies with their primary care physician. This blog by Dr. Jackson Griggs, CEO of Waco Family Medicine Center, explores how his FQHC leveraged the trust of its community to promote positive behavior change during the COVID-19 pandemic while also promoting equity in practices and policies and encouraging vaccine uptake.
Revcycle Intelligence: (3/4) - Organizations like Collaborative Health Systems (CHS) are helping providers transition to value-based care through providing practitioners with resources they cannot afford upfront to take part in such models. Next Generation ACOs sponsored by CHS have generated $54.2 million in savings since 2017, returning about $33.2 million back to providers through shared savings payments. CHS is planning to move some of its participants in Next Gen ACOs to the Direct Contracting Model, and is preparing physicians and practices for success by providing them with tools, data, and the workflow to support the level of care required.
Fierce Healthcare: (3/4) - According to a report by the American Medical Association, Medicare physician spending declined by $9.4 billion (19 percent) in the first six months of 2020 as a result of COVID-19. The report also showed that Medicare spending on physician services dropped 57 percent below expected pre-pandemic levels in April.
Inside Health Policy: (3/3) - The Senate version of the American Rescue Plan Act included $8.5 billion in funding for provider relief. While not the $35 billion that providers had advocated for, the funding would support rural providers that have been impacted financially by the COVID-19 pandemic.
Fierce Healthcare: (3/3) - Humana and the University of Houston launched a course aimed at assisting health professionals in learning how to implement value-based care. The specialization track includes six courses and a capstone project, and will focus on embedding value-based care into the education of medical students to help with the process of shifting away from a fee-for-service health care system.