AJMC: (12/15) - A recent study by the American Journal of Managed Care measured the variation in spending and inpatient prices associated with the primary care physician practice to which patients are attributed. The study found that physician practices account for significant variation in spending, reflecting variation in utilization and price of care delivered by practices, and provides recommendations for how to reduce spending.
Fierce Healthcare: (12/15) - Startup Papa Health, which was created to offer assistance and address loneliness for older adults, is launching a new platform to expand into virtual primary care and chronic care management. The service aims to improve health outcomes for older adults and help facilitate medical care in the home, especially during the pandemic.
Healthcare Dive: (12/14) - Members of Congress reached an agreement on surprise billing on Friday, which could be included in a year-end appropriations bill expected this week. The approach proposed would settle disputes between health plans and providers through an independent arbitration process, an approach that has been favored by providers.
Fierce Healthcare: (12/14) - The COVID-19 pandemic has made the case for why the fee-for-service model is unsustainable, marking the need for a shift in how health care is funded and delivered moving forward. As such, 2021 has the potential to be a landmark year for more widespread adoption of value-based care across the health care system.
Healthcare Dive: (12/11) - The Trump Administration released a proposed rule that would ease a number of standards established in the HIPAA privacy law. The proposed rule would remove certain barriers to value-based care, including allowing plans and providers to use health data more broadly to improve care coordination and case management of individual patients.
Revcycle Intelligence: (12/10) - A group of bipartisan policymakers unveiled a $908 billion COVID-19 relief bill, which included several provisions to support health care providers. The Bipartisan Emergency COVID Relief Act of 2020 would add $35 billion to the Provider Relief Fund (PRF), $7 billion of which would be directed toward rural health providers and $1 billion of which would be directed toward the Indian Health Service. The bill would also change PRF reporting requirements and allow health systems to move targeted distributions within their system.
Fierce Healthcare: (12/10) - Humana unveiled its plans to expand its use of the CMS Primary Care First model to qualified primary care providers across 48 states and D.C. who are in-network for its Medicare Advantage PPO and HMO plans. Humana will offer participating providers a monthly prospective capitation payment under the model, which could be helpful for providing consistent revenue streams for providers whose finances have been impacted by the pandemic.
Fierce Healthcare: (12/10) - Elation Health, which provides a clinical technology platform for independent primary care practices, pivoted quickly to support independent practices during the COVID-19 pandemic. The company integrated telehealth capabilities into its platform to assist independent practices with conducting virtual care visits, which helped mitigate overall declines in practice visits with a decrease of only 30 percent during the pandemic.
Health Affairs: (12/9) - A recent study by Health Affairs found that lower-income adults in the United States fare relatively worse on measures of affordability and access to primary care compared to those in ten other high-income countries.The study found that low-income adults in the US were less likely to have a regular provider or place of care, and were more likely to skip necessary care visits or follow-ups due to cost.