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This Week in Physician-Led Care

November 11 to November 18, 2020

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. 

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Administrative Updates

GAO: (11/13) - GAO issued a report finding that enrollment in private health insurance plans in the individual, small group, and large group markets was highly concentrated among a small number of issuers in 2017 and 2018. For example, for each market in 2018, at least 43 states (including the District of Columbia) were highly concentrated.

CMS: (11/12) - CMS released a weekly enrollment snapshot of week 1 of the 2021 open enrollment period, finding that 818,365 people selected plans using the HealthCare.gov platform.

Legislative Updates

Sen. Smith: (11/12) - Sens. Klobuchar (D-MN), Sanders (I-VT) and Smith (D-MN) led six Senators in a letter to FEMA Administrator Gaynor and HHS Secretary Azar urging the Administration to send additional health care professionals to states experiencing a surge in cases and a shortage of medical staff available to treat infected patients.

Member News

Los Angeles Business Journal: (11/16) - Dr. Jerry Abraham, board member of the California Medical Association, discusses the financial struggles many primary care practices are feeling in Los Angeles. As many as 10 percent of small primary care practices have closed due to COVID-19, and another 25 percent of small practices are at risk of closing.

Surescripts: (11/10) - Aledade improved its star ratings with enhanced medication history for diabetes, cholesterol and hypertension, eliminating 585 unnecessary patient interventions out of 2,235 opportunities identified from payer claims data, which reduced false positives for medication non-adherence by 26%. 

The Washington Post: (11/10) - Aledade CEO Farzad Mostashari wrote an op-ed about the need to enforce coronavirus safety measures that have been relaxed since the summer, including calling for more personal protective equipment for front-line health workers, nationwide testing and contact tracing.

News Clips

American Council on Science and Health: (11/17) – A recent study of the patient-centered medical home (PCMH) for primary care model examined which services lowered costs at 400 practices that employed 20,000 physicians. The study found that only two measures were associated with consistent reductions in expenditures - registries of reminders for necessary screenings and a registry to aid clinicians in pre-planning to incorporate population health monitoring into visits.

Health Affairs: (11/16) – In this blog, Health Affairs proposes a Better Care Plan for the US health care system, which would involve a payment approach that promotes and rewards better care that is continually improving and pays providers and provider networks upfront. This plan would also pay providers a predetermined risk-adjusted amount per person per month so that physician organizations have predictable revenue streams and incentives to improve care.

Medical Economics: (11/16) – In an interview with Medical Economics, Dr. Jacqueline Fincher, president of the American College of Physicians, discussed the impact of overturning the Affordable Care Act on primary care physicians in the middle of a pandemic.

NY Times: (11/15) – As a result of COVID-19, doctors and nurses are retiring early or leaving their jobs due to worries about their own health and safety or needing a break from the stress endured during the height of the pandemic. An analysis from the Larry A. Green Center found that nearly a fifth of primary care clinicians say someone in their practice plans to retire early or already has due to the virus.

Becker’s Healthcare: (11/13) – Health system executives see value-based care models as a way to improve finances, especially when evaluating the impact COVID has had on non-urgent care. At the Becker’s CEO + CFO Virtual Event, two experts shared five key takeaways for how health systems can take on advanced risk-based contracts.

Health Leaders: (11/13) – The pandemic is helping to reshape the health care system and clinical care in many ways, including accelerating the adoption of innovations like telemedicine. COVID-19 has also been changing the approach and priorities related to value-based care at hospitals and health systems, including approaches to deliver valuable programs in the home.

Harvard Business Review: (11/13) – While telehealth has been widely adopted and viewed favorably among consumers during the COVID-19 pandemic, not all providers have bought into virtual care. Provider comfort and ease with telehealth has increased, but many providers are wary of virtual care and its potential to add additional technological and administrative burdens.

Revcycle Intelligence: (11/13) – A new survey from the Healthcare Financial Management Association (HFMA) found that the pandemic has impacted patient collections strategies. The survey revealed that one in five providers are overhauling their entire patient collections strategy as a result of the virus. Additionally, 70 percent of providers have increased patient payment options and 74 percent have adjusted bad debt placement timing.

MedCity News: (11/12) – Independent physician practices play an important economic role in the commerce and jobs they create, in addition to the role they play in the health and welfare of their patients. Non-medical issues such as administrative burden and lack of resources increasingly pose economic challenges on independent practices, even before COVID-19.

Health Affairs: (11/12) – The acceleration in savings observed in ACO models is largely an artifact of selective entry and exit of ACOs based on their established spending relative to benchmarks. This blog discusses how using benchmark-based calculations is not an effective way of measuring program success.

Revcycle Intelligence: (11/12) – A new study published in JAMA Network Open highlights urban-rural primary care workforce disparities, finding that the density of providers in urban areas remains higher than in rural areas despite increases in primary care clinicians in both areas. Additionally, 82 percent of rural counties are classified as medically underserved.

Health Affairs: (11/12) – This blog explores the results from ACO models in the past eight years of Medicare experimentation and the real-time experiences of health care delivery during the COVID-19 pandemic.

Modern Healthcare: (11/11) – This blog was written by a member of the Health Care Transformation Task Force in response to CMS Administrator Seema Verma’s op-ed stating that value-based care needs a course correction. The group does not believe the evidence suggests that value-based care models are not saving money, and rather a better way to evaluate the models is needed.

Medical Economics: (11/11) – A new study found that in the first few months of the pandemic, people of color and those with lower incomes continued in-person visits with their providers at higher rates compared to white patients and those with higher incomes. Conversely, patients who were white and had higher incomes used telemedicine at higher rates.

Events

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If you would like your event to be included in the next newsletter, please email kristen@physiciansforvalue.org.

Partnership to Empower Physician-Led Care

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