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.
CMS: (1/19) - CMMI published a blog on the Geographic Direct Contracting Model and its potential to improve population health. The model is designed to ensure that every beneficiary has an entity accountable for their health care cost and quality. By making geography the unit of change and enabling care transformation for an entire community, CMMI hopes the Geo model will improve the quality of health care delivered to the people within it.
CMS: (1/19) - CMS released the Comprehensive Primary Care Plus third annual evaluation report and associated materials. CPC+ practices continued to use the substantial supports CMS, payer partners, and health IT vendors provided to make important changes in care. There were only a few small favorable effects on service use and quality-of-care measures for Medicare FFS beneficiaries, while total Medicare expenditures including enhanced payments increased.
CMS: (1/19) - CMS noted in the Paving the Way to Equity: A Progress Report from 2015 to 2021 that CMS will continue to promote and expand upon its current efforts to support providers in small practices, and those in rural and underserved areas, through the Quality Payment Program as they transition to Advanced Alternative Payment Methodologies and the Merit-Based Incentive Payment System, as well as through other CMS payment systems and models.
HHS: (1/15) - HHS announced changes to the reporting timeline for the Provider Relief Fund (PRF) due to the recent passage of the Coronavirus Response and Relief Supplemental Appropriations Act. PRF recipients will now be required to submit their reporting requirements on their use of these funds later than previously announced, but can begin registering for gateway access to the Reporting Portal where they will submit their information in compliance with new reporting requirements.
CMS: (1/15) - CMS released HHS Secretary Azar’s response to the Physician-Focused Payment Models (PFPMs). The Secretary is required to review the comments and recommendations submitted by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) and post a detailed response to these recommendations.
CMS: (1/15) - CMS released the Geographic Direct Contracting Model Request for Applications (RFA) and associated materials. CMS expects to accept applications for Geo from March 1 – April 2, 2021. CMS has identified ten target regions for this Request for Applications.The RFA can be found here.
CMS: (1/13) - CMS released the Performance Year 4 (2019) partial financial and quality results for the Next Generation ACO Model. CMS plans to release full PY 2019 results in the spring of 2021 once CMS has completed financial settlement for PY 2019 for all ACOs.
CMS: (1/13) - CMS released its “Putting Patients First: The Centers for Medicare & Medicaid Services’ Record of Accomplishments from 2017-2020” report, which examines CMS’ accomplishments over the past four years and how the agency furthered its Four Core Goals identified in 2017. The report also highlights 16 strategic initiatives that resulted in major regulatory actions, changes in guidance, and streamlined processes and procedures – including the reorganization of CMS.
NEJM: (1/13) – CMMI Director Brad Smith published an article providing a 10-year retrospective on CMMI. While noting the importance of experimenting and aiming to improve value-based care, Smith noted that most models have not achieved sufficient savings nor improved quality largely due to program design features. He highlights lessons learned over the past decade and eight recommendations for CMMI moving forward.
HHS: (1/11) - HHS awarded over $8 million to fund the Telehealth Broadband Pilot (TBP) program. The TBP program assesses the broadband capacity available to rural health care providers and patient communities to improve their access to telehealth services.
HHS: (1/11) - HHS Office of the National Coordinator for Health IT (ONC) issued a blog highlighting the Health Information Technology Advisory Committee (HITAC) recently approved report and set of recommendations developed by the Intersection of Clinical and Administrative Data (ICAD) Task Force. The final fifteen recommendations support HHS’ priority to reduce the burden of clinical documentation.
Fierce Healthcare: (1/19) - Aledade raised $100 million in a Series D funding round to help achieve better health outcomes for patients through risk-taking contracts across all types of payers, with remarkable growth in Medicare Advantage.
Florida Medical Association: (1/19) - In this episode of the Florida Medical Association’s Podcast, Dr. Amaryllis Sacnhez Wohlever discussed how to improve physician wellness and combat physician burnout with FMA CEO Timothy Stapleton.
Aledade: (1/19) - In this episode of Aledade’s ACO Show, Travis Broome and Brian Chiglinsky discuss the Direct Contracting Model, the newest Medicare total cost of care model, and what practices thinking about venturing into value-based care should consider.
MGMA: (1/18) - MGMA released a special report identifying key learnings from 2020 and providing important priorities that medical practices should consider heading into 2021. The review is a culmination of MGMA’s national weekly pools of more than 4,800 health care leaders on the biggest issues and trends in medical practice management and the health care industry.
Medical Economics: (1/14) - According to the 2020 Medical Economics Physician Report, getting paid is regularly listed as a top challenge facing physicians, a trend that will not change in 2021. To ensure they get paid in 2021, physicians need to focus on understanding new changes to Evaluation and Management (E/M) codes made by CMS, mastering telehealth payments, and embracing data. Aledade CEO Farzad Mostashari also said that breaking the fallacy that fee-for-service is a good way to pay for primary care is key, and that payments should be based on the value created and be more person-based.
Delaware Business Times: (1/18) - In this op-ed, the author makes the case for investing in primary care to foster a healthy workforce and emphasized the need for the health care system to shift to value-based care. The Office of Value-Based Health Care Delivery within the Delaware Department of Insurance was created to focus on these areas, and has plans to double primary care spending in the commercial market by 2025.
Revcycle Intelligence: (1/14) - Partial performance data from CMS shows that the Next Generation ACO model saved Medicare $558 million in 2019, while maintaining an average quality score of 93.7 percent. After accounting for shared savings paid to ACOs, the 37 Next Generation ACOs that participated in the model in 2019 produced net savings of $204 million for the Medicare program. Full 2019 performance data is expected to be released in spring 2021.
Modern Healthcare: (1/14) - Modern Healthcare interviewed outgoing CMS Administrator Seema Verma on her work at CMS during the Trump Administration, ranging from topics including the need to revamp what CMMI does to eliminating the Medicaid fiscal accountability regulation (MFAR). On CMMI, Verma noted that the new models put in place have been strategically chosen as ones that will have the largest impact on the health care system. She also emphasized the need to continue working toward value-based care in the health system, as it is something that has bipartisan support.
Revcycle Intelligence: (1/13) - The COVID-19 pandemic did not halt mergers and acquisition activity in the health care system, and will likely serve as a catalyst for continued strategic activity in 2021. A recent survey of health care CFOs conducted by BDO revealed that 44 percent of CFOs believe the pandemic will drive an increase in partnerships in 2021 and 41 percent expect an increase in consolidation.
AJMC: (1/13) - To meet the changes to health care delivery resulting from the ongoing COVID-19 pandemic, physicians affiliated with the Council for Accountable Physician Practices (CAPP) have worked to increase investment strategies in areas such as value-based care to address disparities in care that have been exacerbated by COVID. This video, featuring a conversation with Dr. Norman Chenven from CAPP, explores such investments in more detail.
Forbes: (1/13) - The shift toward value-based care is accelerating at the same time that demand for better transparency, lower technology costs, and increase in telehealth is rising. Technology and analytics in health care can accelerate the transition to value-based care models, especially in the wake of the pandemic. This article explores strategies to leverage technology to advance this movement.
Healthcare Innovation: (1/12) - America’s Physician Groups released a press release calling for the incoming Biden Administration to accelerate the movement to value and strengthen the Medicare Advantage program to drive better value in health care. One recommendation, particularly if the Biden Administration moves forward with a public option, included adopting budget-based prospective payment models for physician groups. The group also noted how Medicare Advantage plans are playing a crucial role in the shift to value-based care and health plans should be actively supported.
ChenMed: (January 2021) - In this episode of the Business of Healthcare Podcast, Dr. Bob Kaiser talks with Dr. Gordon Chen, CMO at ChenMed, about how ChenMed is turning fee-for-service care on its head by delivering mission-driven value-based care to its patients.