News Clips
Healthcare Dive: (5/11) - Stakeholders in the health care industry have grown frustrated with the lack of clear information around what remains in the Provider Relief Fund and how and when those remaining funds will be available to providers. Some providers have not yet received funds for the fall and winter months, when several practices were hit hard by surges in COVID cases and faced significant losses. According to HRSA, about $24 billion in funds remain in the Provider Relief Fund as of May 5, in addition to the $8.5 billion allocated to rural providers by the American Rescue Plan. Providers, however, still feel left in the dark.
Modern Healthcare: (5/7) - To reduce vaccine hesitancy, health care stakeholders say that increasing access to COVID vaccines in primary and outpatient care settings could make a difference. Primary care offices in particular serve as a regular source of care for many individuals compared to the mass vaccination sites that were highly utilized at the start of the vaccine rollout. As demand for the vaccine decreases, primary care physicians can play an important role in speaking to their patients about the vaccine and being trusted partners in patient care.
Modern Healthcare: (5/6) - According to two recent analyses, having an effective public option with lower premiums would mean cuts to provider rates would be likely, as it is considered a main way to reduce premium costs. A Brookings Institute analysis acknowledged that a public option could be harmful to providers in rural areas or other vulnerable settings that have to choose between harming patient care and cutting costs. A separate brief by the Center for American Progress found that lowering provider rates would be a key element of success for a public option, but maintained that payment rates for rural and safety-net providers, community health centers, and others should still be sufficient.
Revcycle Intelligence: (5/6) - According to a recent analysis by the American Medical Association, more providers are beginning to shift away from private practice and toward hospital-owned practices in recent years. The analysis found that 49 percent of AMA physicians worked in physician-owned practices by 2020, down from 54 percent in 2018.
JAMA Health Forum: (5/6) - Given the recent transition to a new administration and a decade of models coming through CMMI, now is the opportune time to assess the path forward for alternative payment models (APMs). This article proposes a new approach to testing APMs compared to the approach CMMI has taken over the last 10 years of developing and testing several models, outlining the need to recognize the overlap and interactions among models and move to a portfolio paradigm in which a set of complementary models is offered to meet policy goals.
JD Supra: (5/6) - In the second of a five-part series discussing value-based care regulations, this article outlines the concept of creating a value-based enterprise to satisfy requirements in regulations adopted by CMS last year - a Stark value-based exception and Anti-Kickback statute value-based safe harbor. The goal of such an enterprise is to increase efficiencies in the delivery of care and improve outcomes for that patient population.
NEJM: (5/5) - As vaccine rates have plateaued and declined in some places in recent weeks, many are beginning to grow concerned about COVID vaccine hesitancy and how not involving primary care practices in the process could further hinder progress and undermine equity in the vaccine rollout. This article suggests that ready access to vaccines at usual sources of care may be critical in reaching those who are receptive or neutral toward receiving the vaccine, and that primary care clinicians and trusted health care organizations have working relationships with community leaders and have earned trust with patients to address this issue at the local level.
Modern Healthcare: (5/5) - Several studies have recently been published outlining how health care costs and low-value care typically increase when independent or small physician practices are acquired by hospital systems. While vertical integration can facilitate more coordinated care, evidence has shown it can also lead to increased costs due to shifts in referral patterns and more low-value care. A study of primary care doctors in Massachusetts who transitioned to hospital-owned employment, for example, found that the odds of a patient receiving an inappropriate MRI scan for back, knee or shoulder pain increased over 20 percent after an independent practice physician transitioned to hospital employment.
Modern Healthcare: (5/5) - The American Medical Association released its Physician Practice Benchmark Survey, finding that the number of physicians working in physician-owned practices fell below 50 percent for the first time. This drop has corresponded with a rise in employment by hospitals, health insurers, and private equity firms. For example, 40 percent of physicians worked for hospitals or practices at least partially owned by hospitals in 2020, up from 29 percent in 2012. This often varied by age and specialty, but has also been a result of the economic impacts of COVID-19.
MedPage Today: (5/5) - Last week, the National Academies of Sciences, Engineering, and Medicine (NASEM) released a report outlining an evidence-based plan with objectives and recommendations for implementing high-quality primary care in the US. The report listed five steps that should be taken to do so, including: 1) pay for primary care teams to care for people, not doctors to deliver services; 2) ensure that high quality primary care is available to every individual and family in every community; 3) train primary care teams where people live and work; 4) design information technology that serves the patient, family, and interprofessional care team; and 5) ensure that high quality primary care is implemented in the US.
American Hospital Association: (5/5) - The American Hospital Association (AHA) sent a letter to HHS Secretary Xavier Becerra urging him to extend the deadline for providers to use COVID-19 Provider Relief Fund payments, which is now set for June 30. The AHA asked Secretary Becerra to extend this deadline to the end of the public health emergency, given the expenses providers continue to face related to COVID and the need to apply Provider Relief Fund funding toward personal protective equipment, maintaining testing, and other services.
Revcycle Intelligence: (5/4) - Vertical integration has significantly increased in the health care market in recent years, leading to higher costs. A recent Health Affairs study found that vertical integration increased referrals to hospitals and increased Medicare spending as a result, for example. A separate Health Affairs study found that hospital employment of physicians in Massachusetts was associated with inappropriate diagnostic care.
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