Administrative Updates

CMS: (12/1) - CMS issued the 2021 Physician Fee Schedule (PFS) final rule, setting payment rates for 2021. Fact Sheet

CMS: (11/25) - CMS announced steps to increase the capacity of the health care system to provide care to patients outside a traditional hospital setting amid a rising number of COVID-19 hospitalizations across the country. The flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Acute Hospital Care At Home Initiative ASC flexibilities

HHS: (11/25) - HHS issued a request for supplemental evidence and data submissions on models of care that include primary care for adult survivors of childhood cancer. Comments are due by December 28.

HHS: (11/25) - HHS issued a request for information (RFI) to determine which regulations that have been made by HHS in response to the COVID-19 PHE to support economic recovery have been beneficial or detrimental, and which should be made permanent or temporary. Comments are due by December 28.

HHS: (11/24) - HHS issued a request for information (RFI) on the impact of changes adopted by health care systems and health care providers in response to the COVID-19 pandemic. HHS plans to identify and learn from effective innovative approaches and best practices implemented by non-HHS organizations in order to inform HHS priorities and programs. Comments are due by December 24.

ONC: (11/24) - HHS Office of the National Coordinator for Health Information Technology (ONC) issued the Accelerating API and App Connectivity: Consumer Perspectives report, the first of ONC's planned reports that explore the current landscape of API-based health information exchange. Based on discussions with organizations, ONC learned that when describing the consumer experience with health IT, including portals and healthcare apps, there are two core components necessary to sustain interest and use: 1) the data must be interoperable, detailed, accurate, and timely; and 2) the healthcare app must reduce the amount of time consumers spend obtaining their data and achieving their specific objective.

Member News

Kaiser Health News: (11/30) - The financial stress faced by provider practices during COVID-19 has led several practices to close or downsize, contributing to a reduction in access to primary care in areas that often experience provider shortages. This article highlights several stories reflecting this trend, including results from a survey released in October by the California Medical Association revealing that a quarter of practices saw revenues drop by at least half.

Aledade: (11/30) - Multispecialty clinics increasingly see the value of participation in a Medicare accountable care organization. Aledade published a case study of a large multi-specialty clinic in Utah that saw major improvements in coordinated patient care, an increase in practice revenue, and measurable savings for its partner payers by partnering with Aledade.

Aledade: (11/27) - Aledade released the recording for the Making Telehealth and In-Person Care Work for Primary Care Long-Term webinar, which reviewed sustainable in-person and virtual care practices to help your practice optimize visit workflows and increase patient engagement.

Modern Healthcare: (11/28) - As patients are reluctant to seek care during the ongoing pandemic, primary care physicians are on the frontlines encouraging patients to seek out needed care. President of AAFP Dr. Ada Stewart is trying to encourage patients to seek out needed care by communicating with patients what her practice has done to keep them safe from the virus and providing patients her cell phone number to call her anytime.

News Clips

Milbank Memorial Fund: (12/1) - The trust individuals have in their primary care doctors should play a role in plans to effectively distribute the COVID-19 vaccine. This blog outlines five reasons why primary care teams can play a critical role in making vaccine distribution programs successful.

Medscape: (12/1) - CMS Administrator Seema Verma has indicated in several remarks that CMMI value-based care models have not generated significant savings. This article discusses how this could impact physician income in the coming years and possible changes in value-based care models physicians should expect as CMMI works to improve these models.

Forbes (11/30) - Physicians are often held up as the foundation of the health care system, but the fee-for-service foundation on which the health care system was built puts physicians and health systems at risk of financial instability. While this has been exacerbated by the pandemic, independent physicians could be driving the change needed to navigate the current financial challenges and transform the health care system.

American Medical Association: (11/30) - In a recent webinar hosted by the Behavioral Health Integration Collaborative, experts shared strategies around how to integrate behavioral health and primary care in a way that improves patient care and that is financially sustainable for practices that rely on FFS, VBC payments, or a combination.

Mathematica: (11/30) - Mathematica published a new report summarizing findings from a five-year evaluation of DSRIP demonstrations in four states. Findings revealed how difficult it can be and how long it can take to establish and maintain the infrastructure needed to support value-based payment models in the states, and shared key lessons for future efforts.

Milbank Memorial Fund: (11/30) - Reflecting on the progress of value-based care models and areas in which models can improve, this article discusses how the Biden administration should take transformational approaches to make effective payment policy changes within the health care system. To do so, authors propose the need for incentive rewards or penalties that are substantial and a hard, risk-adjusted specification of quality goals.

Modern Healthcare: (11/30) - In preparation for CMS releasing the 2021 physician fee schedule, experts are suggesting providers evaluate compensation plans and operations. Dr. James Bock, chief physician executive at HSHS Medical Group, said it is difficult to predict how changes will impact primary and specialty care payments when there are still uncertainties around how the pandemic will continue to impact provider practices in the coming months.

Health Affairs: (11/25) - Value-based payment (VBP) structures could help reduce health disparities, and the pandemic has provided health care organizations with such models the flexibility to pivot the way care is delivered. This blog outlines three strategies payers and providers can implement to incorporate health equity in VBP design and implementation.

Events

December

• December 2, Partnership to Empower Physician-Led Care, "Virtual Briefing: Examining Proposals to Increase Health Care Competition.” Virtual.
• December 2, Primary Care Collaborative, “Primary Care Investment 2.0: State Innovation Workshop.” Virtual.
• December 2, Manatt, “Next-Generation Strategies to Transform Pediatric Primary Care.” Virtual.
• December 3, Fierce Healthcare, “Financial Outlook for Physicians for 2021.” Virtual.
• December 4, AAFP and Manatt, “How and Why to Grow Telehealth in Your Practice.” Virtual.
• December 7, Manatt, “Medicaid Managed Care Payment Policies to Support Pediatric Providers.” Virtual. 
• December 9, Aledade, “Why You Should Join an ACO with Primary Care First and Considerations for CPC+ Practices.” Virtual.
• December 10, Modern Healthcare, “Webinar: Leveraging Lab Analytics for Success in Value-Based Care.” Virtual.
• December 10, California Medical Association, “Telehealth Series for Small and Medium Sized Practices: Telehealth Office Workflow.” Virtual.

If you would like your event to be included in the next newsletter, please email kristen@physiciansforvalue.org.