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.
HHS: (1/28) - On January 28, HHS – in accordance with the Executive Order issued by President Biden – announced a Special Enrollment Period (SEP) for individuals and families for Marketplace coverage in response to the COVID-19 PHE. Beginning February 15, 2021 and through May 15, 2021, the SEP will allow individuals and families in states with Marketplaces served by the HealthCare.gov platform to enroll in 2021 health insurance coverage. Fact sheet
Executive Order: (1/27) - President Biden signed an Executive Order establishing the President’s Council of Advisors on Science and Technology (PCAST). Eric Lander, President Biden’s pick for Director and Assistant to the President for the White House Office of Science and Technology Policy (OSTP), will co-chair PCAST. Fact sheet
Rep. Fletcher: (1/28) - Rep. Fletcher (D-TX) and 16 cosponsors introduced the Stop Surprise Medical Billing for COVID-19 Tests Act (H.R. 533), which would prevent surprise medical bills with respect to COVID-19 testing.
Rep. Schneider: (1/28) - Rep. Schneider (D-IL) introduced the Protecting Medicare Beneficiaries with Pre-Existing Conditions Act (H.R. 599), which would provide for the guaranteed issue of Medigap policies to all Medigap-eligible Medicare beneficiaries and Medicare Advantage enrollees.
Sen. Shaheen: (1/28) - Sens. Cassidy (R-LA), Kelly (D-AZ), Scott (R-SC), and Shaheen (D-NH) introduced the Primary Care Enhancement Act (S. 128), which would provide for the treatment of direct primary care service arrangements as medical care, and to provide that such arrangements do not disqualify deductible health savings account contributions.
Rep. Porter: (1/25) - Rep. Porter (D-CA) and 27 bipartisan cosponsors introduced the Medicare Economic Security Solutions Act (H.R. 480), which would limit the penalty for late enrollment under part B of the Medicare Program to 15 percent and twice the period of no enrollment, and to exclude periods of COBRA, retiree, and VA coverage from such late enrollment penalty.
Fierce Healthcare: (2/2) - According to the Annals of Family Medicine, primary care doctors provide almost half of all vaccines in the United States, making their role in the COVID-19 vaccine distribution process critical to accelerate and ensure a successful vaccine rollout to communities, including those harder to reach. MGMA is calling on the Biden Administration to include medical group practices in COVID-19 vaccine distribution strategies moving forward, as many practices feel shut out of the process.
Florida Medical Association: (2/1) - In a new episode of the Florida Medical Association Medicine Curated Podcast, FMA board member Christie Alex discusses the value of physician voices in providing reliable public health information and the most pressing concerns for family medicine and primary care physicians.
USA Today: (2/1) - To date, 16 states have used less than half of distributed doses of the COVID-19 vaccines. A recent survey from MGMA found that 85 percent of independent medical practices had not received any vaccine doses, despite these practices being ready and able to distribute vaccines to tens of thousands of patients across the U.S.
Fierce Healthcare: (1/29) - A new study from MGMA and Humana found that for 87 percent of respondents who deferred care in 2020 due to the pandemic, safety was the top reason, with only 9 percent deferring care due to job or insurance loss.
California Medical Association: (1/28) - California Medical Association released their 2020 year in review, reflecting on their physician-led advocacy from legislation and policy-making, to regulatory and legal affairs, to practice management and reimbursement assistance.
Fierce Healthcare: (1/27) - MGMA sent a letter to the Biden Administration asking medical group practices to be included in COVID-19 vaccine distribution strategies moving forward. Dr. Halee Fischer-Wright, President and CEO of MGMA, highlighted that current distribution efforts take patients away from trusted ties with their physicians, as physician practices have the capacity and strategic ability to proactively deliver the vaccine by identifying patients by age, pre existing conditions and other risk factors.
Fierce Healthcare: (1/27) - Dr. Emily Maxson, Chief Medical Officer of Aledade, wrote this industry voices article outlining why states need to prioritize vaccinating primary care physicians given their integral role in maintaining community health. Primary care physicians have historically been left behind in COVID relief efforts, with many primary care providers and staff unable to get PPE. This has led to 55 percent of health care worker deaths from COVID-19 being among primary care providers.
HealthcareNOW: (2/2) - On this episode of the HealthcareNOW Podcast, Michael Sisti and Lisa Stockdale of Silver Cross discuss how a practical value-based care strategy can be implemented in independent provider communities using examples from their experiences. They also discuss how COVID-19 has significantly impacted the way that independent hospitals and provider communities do business.
Health Affairs: (2/1) - A key priority for CMS in the months ahead will be supporting and stabilizing state efforts around Medicaid. In this blog, authors outline the need for CMS to be more assertive in supporting greater Medicaid reform to improve health and wellbeing for beneficiaries. The blog lays out key recommendations that can be organized in two categories: new models, demonstrations, and programs developed by CMS that could be adapted and implemented by states; and waivers and other investments led by CMS.
Healthcare Financial Management Association: (2/1) - Initiatives to reform the health care payment system and support the shift toward value-based care could also help transform the health care system to be more equitable. This article explores pathways to do so, including emphasizing primary care as a part of health care improvement efforts.
Vox: (2/1) - U.S. health care monopolies have led to the highest medical costs in the world. In his previous role as California Attorney General, HHS Secretary nominee Xavier Becerra oversaw one of the largest antitrust settlements in health care in US history. To tackle market consolidations of hospitals and physician practices, Becerra could take action to increase antitrust enforcement to lower health care costs.
StarTribune: (1/30) - Independent practices in Minnesota are still awaiting vaccine shipments despite being one of the high priority groups in the state. The delay in distributing vaccines to independent clinics, while large health systems received vaccines six weeks ago, was largely due to the state’s hub-and-spoke model for vaccine distribution rooted in the large health systems. Staff at independent clinics in the state are continuing to seek answers and clarity around when to expect vaccines to be delivered for providers and high-risk patients.
American Medical Association: (1/29) - Two AMA member physicians weighed in on how doctors can best help their patients to overcome COVID-19 fatigue and stay safe. Among the suggestions included recognizing signs of COVID fatigue, seeking mental health care, finding ways to have community, creating a schedule, and continuing to follow preventive measures.
Concord Monitor: (1/29) - Primary care practices in New Hampshire have experienced an inundation of calls and inquiries about vaccine distribution in recent weeks, placing additional pressure on these practices that are already struggling with the level of inquiries received during the pandemic and that do not have the staffing capacity to promptly respond to patients on top of other routine tasks. Small practices feel the state did not have such practices in mind when developing vaccination plans or how patients would receive answers to their questions.
Harmony Solutions: (1/28) - Tracking key performance indicators (KPIs) can be helpful to transition to value-based care, as it can enable providers to gain insight into their specific performance and compare it to pre-determined benchmarks. This article recommends several KPIs to assess progress in the value-based care system: readmission rates, patient-reported outcomes, and patient experience or engagement.
Revcycle Intelligence: (1/27) - Earlier this year, the American College of Physicians published a policy statement calling for adequate physician reimbursement for all COVID-19 vaccines and their administration. The group also made recommendations about the provision and distribution of the vaccine, stressing the importance of communication and collaboration among physicians and other vaccinators to ensure patient safety and continuity of care.
mHealth Intelligence: (1/27) - The Connected Health Initiative launched the Value-Based Care Task Force, which aims to ensure connected health tools and concepts are included in conversations around transforming the health care system to embrace value-based care. The group will publish a white paper outlining how to amend federal laws to support connected health strategies that advance value-based care, change federal regulations to support connected health strategies in payment systems, and work with payers to incentivize connected health in value-based care initiatives.
Healthcare Finance News: (1/27) - In this episode of HIMSS TV, SVP and chief product officer of athenahealth Paul Brient predicts that 2021 will bring more value-based care and telehealth visits will even out.
AHIP: (1/27) - In this blog and episode of the Next Big Thing in Health podcast, AHIP interviewed Dr. William Shrank, Chief Medical Officer at Humana, on value-based care initiatives and the COVID-19 pandemic. Dr. Shrank noted that making the shift to a health care system that focuses on the patient as a consumer and that delivers care and services to the right place at the right time in the workflow of the patient’s life is important in the delivery of health care moving forward.
Fierce Healthcare: (1/26) - A new report from Kaufman Hall revealed that physician net revue was down by 4.5 percent in 2020. The report calls for practices to continue to shift away from fee-for-service Medicare and for the payer mix away from commercial plans to Medicaid due to job losses stemming from COVID-19.