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This Week in Physician-Led Care

November 5 to November 11, 2020

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. 

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Administrative Updates

HHS: (11/4) – HHS issued a notice of proposed rulemaking that would require HHS to review its regulations every ten years to assess whether they are still needed and if they are meeting their intended goals. The rule would require HHS over the next two years to review nearly 2500 regulations to assess whether they are subject to review under the Regulatory Flexibility Act, and if so, whether they are meeting their intended goals.

Legislative Updates

Rep. Axne: (11/5) –On November 5, Rep. Axne (D-IA) sent a letter to President Trump, Senate Majority Leader McConnell (R-KY), and Speaker of the House Pelosi (D-CA) urging the White House and congressional leaders to come to an agreement on COVID-19 relief before the end of the year.

Member News

Healio: (11/10) – The new president of AAFP said that her top priority is increasing payments to family medicine and primary care, as the COVID-19 pandemic has shown how flawed the fee-for-service system is and how undervalued family medicine and primary care have been.

Aledade: (11/10) – Aledade launched a new video series called “With Primary Care, For Primary Care” showcasing what health care can look like when doctors have the freedom and support they need to help their patients and their communities.

MGMA: (11/10) – In a recent advocacy statement on the ONC Task Force Report on Prior Authorization, MGMA asked ONC to address the burden of prior authorization on medical practices, noting that health insurers should reduce the number of prior authorization requests, enhance transparency, and increase automation. 

Revcycle Intelligence: (11/9) – CMS announced that eligible clinicians who have been notified as missing billion information for the payment of APM bonus for the 2018 performance period have until Friday, November 13th to submit the data. MGMA contended that CMS should not tie provider reimbursement for APM participation to the deadline, urging CMS to rescind the current deadline and use the extra time to engage in extensive outreach efforts.

News Clips

Health Affairs: (11/10) - This blog discusses key observations from evaluations of the CMS ACO Investment Model (AIM) implementation. Specifically, the article looks at impacts over the three performance years pertaining to partnerships with management companies, strategies for reducing spending in dispersed markets, and the extent to which single-sided financial risk may suffice to induce care transformation.

Business Wire: (11/10) - Lessons learned from COVID-19 are expected to drive major changes in the health care delivery system. In interviews conducted with leaders at the Council of Accountable Physician Practices (CAPP), physicians identified six major initiatives that should be encouraged to shape the system post-COVID, including accelerating the transition to paying for value and investing in primary care.

Modern Healthcare: (11/9) - In an interview with Modern Healthcare, Humana Chief Medical Officer Dr. William Shrank spoke about the drive to value-based care and findings from Humana’s annual report assessing value-based contracting. He noted that providers who are trying to be successful in both VBC and fee for service are struggling, and that those who fully make the jump to value are seeing great results.

Becker’s Hospital Review: (11/9) - A recent KFF report evaluated Health Professional Shortage Area (HPSA) designations in the United States and found a total of 7,203 areas with a HPSA designation. This article ranks each state based on the number of HPSA designations as of September 30, 2020.

USA Today: (11/9) - Smaller physician practices are struggling to stay open during the pandemic. A recent survey by the American Medical Association found the average revenue in medical practices has dropped by 32 percent, making it difficult for practices to survive under the financial stress resulting from reductions in patient volume and revenue.

Becker’s Hospital Review: (11/6) - A recent study published in JAMA Network Open revealed a 23 percent decline in overall health services in March and 52 percent decline in April for commercially insured beneficiaries, compared to the same time period in 2019. While telehealth use increased rapidly, it was not enough to account for reductions in in-person primary care visits.

American College of Physicians: (11/6) - A recent blog post from ACP advocated against the practice of private insurers eliminating waivers implemented during the pandemic that have been crucial for patient health and physician reimbursement.

AJMC: (11/5) - Willis Towers Watson recently published its 2020 Health Care Delivery Survey, which found that 73 percent of organizations intend to adopt and expand more value-based, employer-provided health care delivery models over the next three years.

Healthcare Finance News: (11/5) - In a recent episode of HIMSS TV, Dr. Karen Abrashkin, the medical director of Northwell Health’s House Calls program, says virtual care tools have allowed providers to connect with senior patients in their homes and enhanced patient-provider relationships in primary care.

Home Health Care News: (11/3) - Humana intends to continue the shift toward value-based care payment models, both with internal service lines and external provider partnerships. In the third quarter of 2020, 86 percent of Humana’s value-based care partners received a higher level of payment than they would have in a fee-for-service arrangement.




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