JAMA Network: (5/4) - The National Academies of Sciences, Engineering, and Medicine (NASEM) released its “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care” report. NASEM organized a committee to study the state of primary care, and to develop an implementation plan that builds upon the recommendations of the 1996 Institute of Medicine report entitled “Primary Care: America’s Health In a New Era” to strengthen primary care services in the US. The report calls for an implementation plan with five objectives that emphasize the need for a federal coordinating function and an evaluation and reporting infrastructure for report recommendations and their influence on health outcomes, which are outlined in this article.
Kaiser Health News: (5/4) - In its recently released report on primary care, the National Academies of Sciences, Engineering, and Medicine (NASEM) called for broad recognition that primary care is a “common good.” Notably among its several recommendations was that all patients in the US across payers should select a primary care provider or be assigned to one, which could significantly change the way health care is delivered. This concept, known as empanelment, has been noted as a way to increase sustained relationships with primary care providers to increase high-quality care.
Health Affairs: (5/3) - Vertical integration has increased in the health care system in recent years, with hospitals and health systems having direct ownership of physician practices. In a new Health Affairs study, researchers looked at the impact of vertical integration on referral patterns for common diagnostic tests and procedures and the associated spending. The study found that vertical integration, combined with differences in Medicare payments between hospitals and non-hospital providers, leads to higher spending in Medicare for these services.
Healthcare Exec Intelligence: (5/3) - Last month, some health insurers allowed cost-sharing waivers for COVID-19 treatment to expire, leaving some to wonder if now is the time to shift financial responsibility back to patients. In this episode of the Healthcare Strategies podcast, Mark Fendrick, Director of the University of Michigan Center for Value-Based Insurance Design, was disappointed in this move, stating that the health care industry needs to bolster high-value spending and the role value-based care can play in this process of determining new cost-sharing strategies.
Milbank Memorial Fund: (5/3) - CMS has launched three primary care models over the past several years to align multiple payers with Medicare - Comprehensive Primary Care, Comprehensive Primary Care Plus, and Primary Care First. This brief looks at state Medicaid agencies’ decision-making around participating in such models, finding that alignment with existing state primary care programs and goals was important for state Medicaid agencies to consider model participation.
Health Affairs: (5/3) - More physicians in the US have been transitioning from independent practice to hospital employment, which has raised concern around whether employed physicians will increase referrals for unnecessary hospital-based services. This study looked at claims to identify if hospital-physician integration is associated with inappropriate referrals for MRIs for three common conditions, finding that such actions increased by over 20 percent after a physician transitioned to hospital employment.
Milbank Memorial Fund: (4/29) - COVID-19 has altered the way primary care has been delivered and accessed by patients. In this report, authors document and analyze trends in primary care over the course of the pandemic and make recommendations to primary care clinical team members, health care industry leaders, and policy experts for care strategies to advance primary care moving forward.
Modern Healthcare: (4/28) - A new study found that primary care providers have a tendency to overestimate the risk of common conditions, including cardiac ischemia and breast cancer, based on symptoms and test results. Although those surveyed were often those who worked with sicker patients which could have contributed to inflated probability estimates, the misaligned incentives that often result from fee-for-service can also be a factor in this trend.
Managed Healthcare Executive: (4/28) - In the most recent episode of the Tuning in to the C-Suite’s Meet the Board podcast, Doug Chaet, President of Value Evolutions and Chairman of the American Association of Integrated Healthcare Delivery Systems, speaks on his thoughts toward value-based care, ACOs, and more.
Healthcare Innovation: (4/27) - A recent survey from the Larry A. Green Center and the Primary Care Collaborative found that 38 percent of primary care providers reported that their practice was administering the COVID vaccine and 42 percent indicated their practice was increasingly partnering with public health and local organizations to prioritize people for vaccination. However, the data revealed that primary care practices indicated they can be doing more to aid in the vaccine distribution process.