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.
White House: (2/2) - President Biden issued a memorandum directing the Federal Emergency Management Agency (FEMA) to maximize assistance – specifically to provide a 100 percent Federal cost share for all work eligible for assistance under Public Assistance Category B.
White House: (2/2) - President Biden announced several actions to increase vaccine supply, including increasing the overall, weekly vaccine supply to states, Tribes, and territories to 10.5 million doses nationwide, launching the first phase of the Federal Retail Pharmacy Program for COVID-19 Vaccination, and increasing reimbursement to states.
CMS: (2/1) - CMS posted the CY 2022 request for applications (RFA) for the Medicare Advantage Value-Based Insurance Design model. Applications are due by April 16. RFA
Expand Medicaid Now Act: (2/5) - Rep. Fletcher (D-TX) introduced the Expand Medicaid Now Act (H.R. 871), which would provide a temporary increase in FMAP for medical assistance under State Medicaid plans which begin to expend amounts for newly eligible mandatory individuals.
States Achieve Medicaid Expansion (SAME) Act of 2021: (2/4) - Sen. Warner (D-VA) and 10 cosponsors introduced the States Achieve Medicaid Expansion (SAME) Act of 2021 (S. 245), which would provide the same level of federal matching assistance for every state that chooses to expand Medicaid coverage to newly eligible individuals, regardless of when such expansion takes place.One-pager
PARENT Act: (2/3) - Sens. Lee (R-UT), Tillis (R-NC), Braun (R-IN), Lankford (R-OK), and Hawley (R-MO) introduced the Parental Accessibility Rights for Emergency and Negligent Treatment (PARENT) Act (S. 206), which would require hospitals and certain other participating providers under Medicaid or the Children's Health Insurance Program to disclose the provider's policy on parental consent for the provision, withdrawal, or denial of life-sustaining treatment for minors.
Parental Right to Know Act: (2/3) - Sens. Lee (R-UT), Tillis (R-NC), Braun (R-IN), and Lankford (R-OK) introduced the Parental Right to Know Act (S. 207), which would require hospitals and certain other participating providers under Medicaid or the Children's Health Insurance Program to disclose the provider's policy on parental access to the medical records of minors.
Improving Access to Health Care in Rural and Underserved Areas Act:(2/3) - Sens. Rosen (D-NV) and Murkowski (R-AK) introduced the Improving Access to Health Care in Rural and Underserved Areas Act (S. 201), which would establish a program ensuring access to accredited continuing medical education for primary care physicians and other health care providers at Federally-qualified health centers and rural health clinics, to provide training and clinical support for primary care providers to practice at their full scope and improve access to care for patients in underserved areas.
Stopping the Mental Health Pandemic Act: (2/2) - Sens. Smith (D-MN), Murkowski (R-AK), and Stabenow (D-MI) introduced the Stopping the Mental Health Pandemic Act (S. 165), which would direct the Secretary of Health and Human Services to award grants to States, political subdivisions of States, Indian Tribes and Tribal organizations, community-based entities, and primary care and behavioral health organizations to address behavioral health needs caused by the public health emergency declared with respect to COVID-19. One-pager
Equal Access to Care Act: (2/2) - Rep. Budd (R-NC) introduced the Equal Access to Care Act (H.R. 688), which would permit a licensed health care provider to provide health care services to individuals in one or more States in which the provider is not licensed. Sens. Cruz (R-TX) and Blackburn (R-TN) introduced companion legislation in the Senate (S. 155).
Bloomberg Law: (2/9) - Physicians across the country feel left out of the COVID vaccine distribution efforts. A recent survey by MGMA found that 85 percent of independent practices not affiliated with a hospital or health system were unable to get the vaccine, and those that did only received enough for one percent or less of their patients. Additionally, AAFP executive vice president Shawn Martin said that state health departments are creating new systems to distribute vaccines when primary care practices are already set up for this purpose, as 54 percent of all vaccines are administered in such settings.
AAFP: (2/5) - In this blog, AAFP lays out why engaging primary care physicians in the vaccine distribution process is critical to reach the necessary COVID-19 vaccination rate. The blog outlines why these providers are best positioned with patients to move the needle on vaccine distribution in the weeks ahead.
Aledade: (2/5) - Aledade published the Comprehensive Guide to Value-Based Care for Primary Care, which is an extensive guide to exploring the fundamental building blocks of value-based care and how practices can incorporate them to thrive in accountable care.
AAFP: (2/5) - On January 29, AAFP sent a letter to the Biden Administration detailing recommendations for strengthening the primary care workforce. The letter reminded the administration of the impending primary care physician shortage and called for several policy initiatives to meet this need.
Fierce Healthcare: (2/4) - Independent practices across the country have grown frustrated with the COVID vaccine distribution process. Such practices have received little information about when they will receive the vaccines, despite the crucial role primary care physicians play in pushing more people to get vaccinated. Aledade member Dr. Gary Birdsall of Louisiana is one of the few independent primary care practices to receive the vaccine, which he claims is due to his persistence in reaching out to state health officials.
Aledade:(2/4) - On February 4, Aledade hosted a webinar entitled “An Introduction to Value-Based Care for Independent Primary Care Practices.” The webinar covered the basics of value-based care, the role of ACOs in value-based care, and how Aledade can help independent practices with the necessary strategies to succeed in value-based care.
The New York Times: (2/3) - Physicians across the US have faced low reimbursement rates for administering COVID-19 tests, sometimes lower than the cost of administering the test itself. The low rates have led some providers to stop testing certain patients or forgo testing altogether, a trend that has been most common with pediatricians using in-office rapid tests. This issue has been raised by several groups, including the California Medical Association, noting that some private health plans were underpaying for COVID testing despite experiencing high profit margins during the pandemic.
Revcycle Intelligence: (2/9) - A new report by Xtelligent Healthcare Media found that large provider organizations and hospitals are better equipped for value-based care contracting compared to small, non-affiliated physician practices. Lower participation rates for small practices are largely due to access to fewer resources, smaller patient populations, and lack of bandwidth to take on value-based arrangements.
Healthcare Innovation: (2/9) – A Commonwealth Fund task force recently developed a list of six health care imperatives to guide the thinking of the Biden Administration on how to improve the performance of the health care system. Among those imperatives included strengthening efficient primary care infrastructure in the US and restructuring how primary care providers are reimbursed.
Health Payer Intelligence: (2/9) – The Value-Based Care Assessment: 2020 by Xtelligent Healthcare Media found that value-based contracting has slowed during the COVID-19 pandemic. Of respondents surveyed, several noted the challenges and uncertainty brought on by the pandemic that have shifted their focus away from transitioning to value-based care models, with 49 percent believing it will take a year for patient volume to stabilize and another 50 percent saying the same of operational performance.
Fierce Healthcare: (2/9) - A new policy brief by the Urban Institute found that primary care practices showed nimbleness during the pandemic by quickly shifting to telehealth services to deliver care. The brief outlined, however, that many practices will need ongoing, targeted federal funding to support providers beyond the pandemic. Some practices also indicated a new willingness to enter into capitation payment arrangements with payers to avoid financial uncertainties of a fee-for-service system.
Fierce Healthcare: (2/8) - The COVID-19 pandemic has accelerated provider and patient adoption of remote health capabilities such as telehealth that have changed the patient experience and led to improved outcomes, enabling the next generation of value-based arrangements. Technological advancements can incorporate the patient experience and lead to innovative value-based arrangements. One such example is with value-based arrangements that act as a vehicle tying value to a therapy based on outcomes rather than cost.
Fierce Healthcare: (2/5) - In response to CMS results on the Medicare Shared Savings Program for 2019, Caravan Health asked the ACOs it advises if ACOs can continue the pattern of success observed in 2019 moving forward given the financial struggle practices have faced during COVID-19. Responses indicated that the ability to adapt to the changing landscape and implement new structures were key to the success of ACOs in navigating the pandemic in three critical ways: streamlined transition to telehealth, better analytics and improved patient engagement.
Health Payer Intelligence: (2/4) - Blue Cross and Blue Shield of North Carolina introduced a value-based care program to improve health outcomes for members with kidney disease through coordinated and patient-centered care. The initiative allows members to enroll in the Blue Premier Advanced Kidney Care program at no additional cost, and will pay providers for the total cost of care and quality performance measures under the model.
Healthcare Innovation: (2/4) - Altais Clinical Services launched in 2020 to help physician groups succeed under value-based contracting through the leveraging of data analytics tools. This interview provides perspectives of the horizon for value-based contracting moving forward and how data analytics can help providers be successful in value-based arrangements.
Healthcare Finance News: (2/4) - In this episode of HIMSS TV, Vivify CEO Eric Rock discusses how we are at a pivotal moment for value-based care and how remote patient monitoring can help realize the possibilities of health care.
Revcycle Intelligence: (2/4) - A new study by Pioneer Institute revealed that direct primary care (DPC) services have the potential to boost care access in Massachusetts by providing the most vulnerable populations with cost-effective, patient-centered care. There are currently 16 direct primary care practices in Massachusetts out of 1,600 nationwide, and the practice has been associated with affordable care for underserved patients and less physician burnout.
The New York Times: (2/4) - Health care providers across the country are feeling fatigue and exhaustion from being on the frontlines of COVID care over the past year. It has even caused several providers to leave the field, such as Dr. Sheetal Khedkar Rao, an internist in Chicago who experienced a 30 percent pay cut to compensate for a drop in patients seeking primary care. This article outlines the ongoing challenges providers are facing a year into the pandemic, including the burnout and lack of appreciation felt by medical workers on the frontlines.
Medical Economics: (2/3) - Many independent practices have struggled financially during the pandemic. With hospital and health system mergers and acquisitions becoming more common, this article outlines how such practices can band together to remain independent and stay in business, including through creating or joining an independent practice association or clinically integrated network.