Welcome to 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.
PEPC Statement on Passage of the
Inflation Reduction Act
The Partnership to Empower Physician-Led Care (PEPC) applauds Congress for passage of the Inflation Reduction Act. As an organization that focuses on independent physicians and practices, we are acutely aware of the impact of rising costs on small businesses. Nationwide, independent practices and physicians consistently deliver high-quality health care to their patients, oftentimes serving as a pillar in their communities.
The current financial climate in this country, combined with rapid health care provider consolidation over the past few years, require Congress and the Administration to do more to speed up adoption of new payment models among independent physicians and practices. This includes policies that level the playing field across practice settings and that make value-based care models available and attainable for independent practices. We look forward to working with policymakers to advance these key priorities, and improve the financial outlook for independent practices and physicians.
CMMI: (8/16) – The Center for Medicare and Medicaid Innovation (CMMI) released the 110 ACO REACH provisionally accepted ACOs and implementation period three participation list, as well as a FAQ document on the application process and results.
Federal Trade Commision: (8/15) – The Federal Trade Commission issued a policy paper and fact sheet highlighting the pitfalls of using Certificates of Public Advantage (COPAs), which purport to shield hospital mergers from antitrust laws in favor of state oversight. The paper details research showing that these COPAs are often detrimental for patient costs, patient care, and health care worker wages.
MGMA: (8/11) – This blog by MGMA discusses the findings of an MGMA Stat poll which asked medical practices how their collections — as measured in days in A/R — have changed in 2022. The article explores ways in which medical practices may need to change how they handle bad debt and days in A/R to combat top challenges in handling collections and days in A/R.
Aledade: (8/7) – This blog discusses the success of Aledade’s 2020 collaboration between Aledade and Community Health Center Association of Mississippi to serve Mississippi’s Medicaid population. The partnership led to an increase of 106 percent in primary care visits from 2019 - despite the COVID-19 pandemic.
HealthAffairs: (8/17) – As part of an ongoing policy dialogue about the merits of Medicare Advantage (MA) and the Direct Contracting/ACO REACH model, Don Crane and George Halverson have posted a response to a June 2022 article by Don Berwick and Rick Gilfillan. This article highlights several recommendations, including shifting 100% of MA to capitated, value-based, physician-group-centric models within a few years and creating a level playing field for competition between MA and ACOs by, for example, establishing a third-party administrator for ACOs to administer a capitated model.
RevCycleIntelligence: (8/16) – This article outlines how the proposals made in the CMS CY2023 Medicare Physician Fee Schedule proposed rule drive value-based care forward by providing incentives for provider groups to consider alternative payment models. Proposed changes to the Medicare Shared Savings Program include providing advanced shared savings payments to certain new accountable care organizations (ACO) that focus on rural and other underserved populations.
Newsmax: (8/11) – Widespread hospital consolidation has suppressed competition, raised prices and reduced choice across the health care sector. FTC has recently taken a more active role in addressing such consolidation, having successfully challenged four separate hospital mergers this year. This article explores this issue in more detail, providing an argument for why fostering competition across all facets of the health care market should be a national priority.
Managed Healthcare Executive: (8/15) – The role of the primary care physician (PCP) is changing. This article dives into a conversation with two PCPs, Ishani Ganguli, M.D., M.P.H., of Harvard Medical School and Brigham and Women’s Hospital and Megan Ruth Mahoney, MD, MBA, chief of staff at Stanford Health Care and a Stanford professor to discuss the changing landscape surrounding PCPs, and trends such as increasing reimbursement and promoting innovations like accountable care organizations that could bolster the role of the PCP.
AMA: (8/15) – In the premier episode of the American Medical Association (AMA) Thriving in Private Practice podcast, Senior Adviser Dr. Kathleen Blake discussed the risks and rewards and the future of private practice with Carol Vargo, the AMA’s director of physician practice sustainability. Dr. Blake notes that with the right support, physicians can build a sustainable private practice and deliver high-quality care.
Milbank Memorial Fund: (8/12) – This case study of Baltimore City, Maryland is the second in a series of case studies designed to assess the effectiveness of various policy initiatives to expand access to primary care in a region, particularly for underserved populations. The state’s innovative Total Cost of Care model and the Maryland Primary Care Program have the long-term potential to improve primary care access in Baltimore, a city with several health professional shortage areas, but local stakeholders expressed a need for more local input in designing incentives for further investment in primary care.
Medscape: (8/11) – The total value of private equity deals in health care in 2019 is estimated at about $120 billion, and it's expected to grow over the coming years. This article discusses the various impacts and opinions surrounding private equity firms buying physician practices and how this shift in ownership may affect the physician practice.
AMA: (8/11) – In this episode of AMA Thriving in Private Practice podcast, Mike Grodus, chief administrative officer at Professional Medical Corporation, addresses recent trends in commercial payer contracts such as “value-based” contracts, cost and quality provisions and telehealth adoption.
Medpage Today: (8/10) – Primary care physicians would need an "infeasible" 26.7 hours each day to provide preventive, chronic disease, and acute care for a typical panel of U.S. adult patients, according to a recent study in the Journal of General Internal Medicine. Findings suggest that with a team-based care model, primary care physicians could bring their working hours down to 9.3 hours per day, and those time savings would largely be in preventive care services and chronic disease care.
RevCycleIntelligence: (8/9) – A new study published in Health Affairs shows that ACO participation in the Medicare Shared Savings Program (MSSP) modestly reduced Medicare spending for patients with serious mental illness. Researchers found that ACOs participating in MSSP achieved small savings for Medicare fee-for-service beneficiaries with serious mental illnesses after five years of participation in the program, with total health care savings at about $223 per person per year.