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This Week in Physician-Led Care

October 14 to October 21, 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

HHS: (10/15) – HRSA awarded nearly $500 million to support the primary health care workforce nationally, with awards to support, recruit and retain qualified health professionals and students through the National Health Service Corps, Nurse Corps, and other workforce development loan repayment and scholarship programs.

HHS: (10/14) – AHRQ published a blog noting the importance of integrating organizational health literacy strategies into primary and specialty care for preventing and managing chronic diseases.

CMS: (10/14) – CMS released a new data snapshot on telehealth utilization among Medicaid and CHIP beneficiaries during COVID-19. The snapshot shows that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.

Legislative Updates

Senator Blackburn: (10/13) – Sen. Blackburn (R-TN) released a letter she led with 30 bipartisan Senators to HHS Secretary Azar raising concerns about the change in reporting requirements for funds received from the Provider Relief Fund (PRF) and urged the Administration to carefully consider policies that disproportionately affect rural and safety net hospitals.

Senator Collins: (10/13) – Sen. Collins (D-ME) released a letter to Senate Majority Leader McConnell (R-KY), Senate Minority Leader Schumer (D-NY) and Senate Finance Committee Chair Grassley (R-IA) and Ranking Member Wyden (D-OR) urging them to advance legislation that would prevent reductions in provider payment, and opposed the payment cuts proposed for certain health care providers in the 2021 Medicare Physician Fee Schedule (PFS).

Member News

AMA: (10/19) – In this article about the 6 best practices to sharpen physicians’ use of telehealth, the Florida Medical Association is highlighted for its involvement in the Telehealth Initiative, which helps physicians implement telehealth services and is key during the COVID-19 pandemic to support physicians in their shift to telehealth models.

MGMA: (10/19) – MGMA’s Medical Practice Excellence Conference has garnered multiple articles in Medical Economics detailing sessions of effective leadership in a crisis, the challenges and rewards of overcoming implicit bias, and how to build self-awareness to become a better leader.

Aledade: (10/13) – Aledade published a blog on leveraging accountable care to sustain primary care practices during COVID-19 using a three-pronged approach to stabilize practice finances. 

Healthcare Finance: (10/13) – Health care leaders are no longer asking if, but how, value-based care should best be implemented. In this article, Aledade co-founder and CEO Farzad Mostashari made the argument for how third-party companies can coordinate value-based care for a population through the creation of a network of independent practices, assisting in building scale, data, and technical capabilities that large health systems otherwise have in place.

News Clips

Modern Healthcare: (10/19) – Health care executives have agreed that COVID-19 has highlighted the need to adopt new payment and care delivery models. Modern Healthcare interviewed the CEOs of Allina Health and Allina Health-Aetna about efforts to sustain VBC during the pandemic.

Fierce Healthcare: (10/19) – Should Vice President Biden win the presidential election in November, he is expected to push value-based care adoption in his health care agenda. One area of focus will likely be around addressing racial disparities in health care.

Becker’s Hospital Review: (10/19) – Payers Highmark, Humana, and Horizon Blue Cross Blue Shield recently published positive results from their value-based reimbursement programs with providers with each payer seeing savings from their models as well as improvements in quality metrics like hospital readmissions, health screenings, and emergency department use.

AJMC: (10/16) – During a recent AJMC webinar on whole-person health care, speakers highlighted approaches for integrating behavioral mental health into value-based care and the whole-patient model to improve health outcomes.

Physicians Practice: (10/15) – Documentation and accurate coding are critical for primary care physicians transitioning to value-based care, but many small practices or independent practitioners lack the technology, care coordination, time, and other resources to improve these areas.

Healthcare Financial Management Association: (10/14) – According to a speech by CMS Administrator Seema Verma, the agency is looking to add pandemic-era waivers to Medicare value-based payment models to spur provider participation and provide more flexibility to providers.

Deloitte: (10/14) – Data from a recent Deloitte physician survey suggests progress has been slow in developing value-based care capabilities, including physician compensation, tools for decision-making, and care models. This report outlines three initiatives to better equip physicians to transition to value-based care.

Medical Economics: (10/14) – As value-based care continues to be adopted, this article provides an overview of the significant issues with the transition from fee-for-service to value-based care.

Revcycle Intelligence: (10/14) - In its latest Healthcare Resiliency Framework Report, the Health Care Payment Learning & Action Network (LAN) revealed that APMs that use population-based payments are key to building resilience in the health care system following a crisis like COVID-19.

Home Health Care News: (10/13) – CMS Administrator Seema Verma and CMMI Director Brad Smith spoke at the Health Care Payment Learning & Action Network (LAN) summit last week, commenting that only five CMMI value-based care models have generated savings. For models to be successful, Verma said they must incorporate design elements that have an element of downside risk and financially attract provider participation, as well as have effective benchmarks to measure model success.

Geneia: (10/13) – The COVID-19 pandemic has advanced the shift toward value-based care and continues to incentivize physicians to choose capitation and value-based payment models. This article provides views on this shift from leaders within the health care industry.

Lown Institute: (10/13) – This article discusses how attention must be given to historically underserved communities when moving toward value-based models. To prioritize health equity in value-based care, models should be intentional about reducing disparities, add equity metrics to value-based care, and focus on upstream community benefits.

Revcycle Intelligence: (10/13) – Provider industry groups concerned about some of the proposals in the 2021 Medicare Physician Fee Schedule rule called on CMS to reconsider payment changes that would affect providers struggling financially as a result of the pandemic. Specifically, the group recommended CMS eliminate budget neutrality cuts, expand telehealth coverage, and reconsider quality reporting changes.




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