Welcome to 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: (7/19) - CMS awarded $49 million to organizations on the frontlines of reducing uninsured rates and connecting more children, parents, and families to health care coverage. These awards represent the largest investment CMS has ever made in outreach and enrollment through the Connecting Kids to Coverage program.
CMS : (7/15) – CMS released the 2022 Medicaid and CHIP Beneficiary Profile and Infographic, which provide an overview of the enrollment, expenditures, characteristics, health status and experience of the beneficiaries served by Medicaid and CHIP.
HHS: (7/15) – HHS Secretary Becerra renewed the public health emergency (PHE) for an additional 90 days, meaning the PHE will now run through October 16, 2022.
New England Journal of Medicine: (7/14) - The leaders of CMS penned a Perspective piece on expanding accountable care’s reach among Medicare beneficiaries. By better aligning its initiatives and policies related to ACOs, CMS hopes to create pathways for payers and providers to advance high-quality, accountable care.
The White House: (7/12) – The Biden Administration announced its strategy to manage BA.5 – a subvariant of the Omicron variant that currently accounts for a majority of COVID-19 cases in the U.S. The Administration will continue mobilizing the full strength and capabilities of the federal government and work with state and local leaders, health care workers, the private sector, and community- and faith-based organizations.
MedPAC: (7/19) - The Medicare Payment Advisory Committee (MedPAC) released its 2022 data book on health care spending and the Medicare program, which provides data on Medicare spending, demographics of the Medicare population, beneficiaries' access to care, and quality of care in the program. Notably, the data book contains a section on alternative payment models, noting that 72 percent of Medicare beneficiaries with both Part A and Part B coverage are in Medicare managed care or ACO models.
Healthy Future Task Force: (7/14) - Healthy Future Task Force co-chairs, Reps. Guthrie (R-KY) and Buchanan (R-FL), and its Affordability Subcommittee announced the Task Force’s solutions to make health care more accessible and affordable. Among the priorities outlined include lowering costs and increasing choice through competition, including by ensuring the FTC is correctly utilizing its statutory authority to investigate harmful consolidation and promote competition, and building upon site-neutrality rules from the previous Administration.
Aledade: (7/14) – Aledade published a blog on the new CY2023 Physician Fee Schedule proposed rule from CMS. The blog outlines several provisions of the rule, including changes to the Medicare Shared Savings Program, proposed benchmarking changes for 2024, and other relevant provisions for providers in ACOs.
Aledade: (7/13) – In this blog, Aledade President Mat Kendall reminisces about the start of Aledade eight years ago and the organization’s simple mission to advance health care. Aledade’s philosophy has been to give primary care professionals the tools, technology, and team to help them succeed in value-based care models, a target the organization has achieved and grown.
AAFP: (7/13) – The American Academy of Family Physicians (AAFP) marked its 75th anniversary in June. AAFP News recently sat down with the Academy’s student, resident, and new physician members of the Board of Directors to discuss their vision of the specialty’s future. The interviewees reflected on AAFP’s focus on accelerating the transition to value-based care while ensuring family physicians have the financial and technical support needed to be successful.
McKinsey & Company: (7/19) – Two years of the COVID-19 pandemic have shifted the dynamics in the US health care value chain. The acceleration of value-based care models and increasing application of technology across the health care industry is something that will continue beyond the pandemic. The progression of value-based care and related risk payments as well as digitization of the value chain is shifting value creation across, rather than within, traditional health care subsectors.
KHN: (7/18) – The Federal Trade Commission (FTC) is primed to more aggressively combat consolidation in the health care industry than it has in past years. Last year, President Joe Biden ordered the FTC and other federal agencies to promote market competition in health care and other industries. Hospital mergers and acquisitions had left the 10 largest health care systems in control of a quarter of the market and led to the closure of hospitals in rural and other underserved areas, putting pressure on physicians to sign contracts that prevent them from working for competitors in the same market or state.
KHN: (7/18) – The Biden Administration has ordered the FTC to combat consolidation in the health care industry, saying that it is driving up prices for consumers and limiting their access to care. The FTC has signaled that it will be looking at traditional mergers among hospitals and other health care providers, and is interested in some legal theories of antitrust enforcement that have been less frequently used. Kaiser Health News spoke to the Assistant Director of the FTC’s Bureau of Competition on these efforts in this interview.
Medical Economics: (7/18) – Primary care physicians remain in demand, but the starting salaries for specialists continue to outpace those of primary care physicians. While the average starting salary for internal medicine physicians rose five percent, it did not land on the top 10 list for physician average starting salaries. However, primary care physicians “still have an important role to play” for care coordination for older patients, along with implementing value-based reimbursement models and accountable care organizations built on those models.
Medical Economics: (7/18) – Payers and providers in a value-based contract share the goals of managing care quality, costs, and outcomes for a given population. Unfortunately, access to and impact of available patient and member data remain significant hurdles. Many practices have concluded that the cost of establishing data management infrastructure exceeds the benefit of participating in value-based agreements. This article discusses various solutions to overcome those challenges so that both payers and providers can reap the benefits of value-based care.
Health Affairs: (7/15) – CMS leaders recently penned a Perspective piece that reflects on the past and lays out a future vision for accountable care organizations (ACOs). The authors of this blog propose the Administration offer an opportunity for Medicare Shared Savings Program (MSSP) ACOs to participate in primary care hybrid payment models, as offering optional, partial capitation payments within total-cost-of-care models such as MSSP can effectively drive value transformation.
STAT News: (7/14) – The pandemic has made clearer than ever the vital roles that primary care providers play in communities, yet many independent practices are under financial strain and are being acquired by hospitals or private equity firms. A meaningful step forward to address this would be to empower primary care with flexible, adequate payments and technology so all practices can integrate physical, mental, and social supports, and partner with other service sectors.
American Medical Association: (7/14) – In this episode of AMA Thriving in Private Practice, AMA’s vice president of professional satisfaction Christine Sinsky, MD, joins the conversation to discuss how burnout shows up in private practices, how the AMA is addressing burnout and tools to improve physician well-being.