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.
Centers for Medicare and Medicaid Services (CMS): (8/31) – CMS released the first annual report for Pennsylvania’s Rural Health model. While the model attracted a range of participants from a variety of hospital types, hospital participation was lower than anticipated, resulting in challenges to achieving scale targets and a smaller share of revenue covered by the global budget.
CMS: (8/31) – CMS released the first evaluation report for Vermont’s All-Payer ACO model. While the Vermont All-Payer Model failed to achieve its all-payer and Medicare scale target goals, the Model achieved statistically significant Medicare gross spending reductions at both the ACO and state levels, as well as Medicare net spending reductions at the state level. In addition, there were declines in acute care stays (at the ACO and state levels) and in 30-day readmissions at the state level.
House Ways and Means Committee: (9/7) The House Ways & Means Committee released the draft text for several major provisions under consideration in the Build Back Better Act. The Committee is set to hold a markup of these measures on Thursday, September 9. The text released today included language about expanding Medicare coverage to include dental, vision and hearing and about shoring up skilled nursing facilities.
Rep. Jayapal (D-WA): (9/3) – Rep. Jayapal (D-WA) and 129 cosponsors introduced the Improving Medicare Coverage Act (H.R. 5165), which would lower the Medicare eligibility age to 60.
Aledade: (9/3) – Aledade’s policy team provided their recommendation for a flexible and equitable payment model for telehealth services in their new policy paper Getting the Price Right: Looking Toward the Future of Telehealth.
Annals of Internal Medicine: (9/7) – In this position paper, the American College of Physicians considers the effect of mergers, integration, private equity investment, nonprofit hospital requirements, and conversions from nonprofit to for-profit status on patients, physicians, and the health care system. The steady growth of corporate interest and influence in the health care sector over the past few decades has created a more business-oriented health care system, but experts fear that such moves favor profit over care and erode the patient–physician relationship.
The Health Care Payment Learning & Action Network (LAN): (9/7) – In a new podcast, LAN Senior Advisor Aparna Higgins interviews Families USA Executive Director Frederick Isasi, taking a deep dive into existing health disparities and creating solutions to improve health equity within the U.S. healthcare system through alternative payment models (APMs) and addressing structural barriers to access on both the patient and the provider side.
Fierce Healthcare: (9/6) – Providence has slated more than $220 million toward hiring and retaining more healthcare professionals. From sign-on incentives to organization wide bonuses, the large nonprofit system’s new investment looks to head off a nationwide shortage of nurses and other healthcare employees that has left many organizations struggling to treat an influx of COVID-19 patients.
MedCity News: (9/6) – A new study published in the Journal of General Internal Medicine suggests that ACOs may not be cutting costs as expected. The researchers compared financial performance data from all four CMS ACO programs from 2005 to 2018 and found that CMS’ ACO programs roughly broke even.
Modern Healthcare: (9/6) – CMS released a report showing that the first two years of the Vermont All Payer program kept patients healthier while reducing costs, saved money on Medicare patients and kept more people out of the hospital.
Medical Economics: (9/5) – Efforts to combat physician burnout usually focus on individual doctors through programs aimed at building resiliency and dealing with stress resulting from systemic factors such as heavy workloads and loss of individual autonomy. But a new study suggests that reducing burnout requires an organization-level response — creating medical practice cultures that value qualities such as teamwork, open communications and process improvement.
Modern Healthcare: (9/3) – For the second time in 2021, healthcare hiring crossed into negative territory. Healthcare employment contracted by an estimated 4,900 jobs in August, preliminary data from the U.S. Bureau of Labor Statistics show. That's after a healthy rebound in July that saw 29,100 new hires.
Modern Healthcare: (9/3) – Beaumont Health and Spectrum Health have taken a step forward in their quest to create Michigan’s largest health system, signing a formal integration agreement that spells out more details on how they would combine. They said that following the agreement, they hope to launch the combined health system by this fall pending regulatory approvals.
STAT News: (9/2) – Hospital mergers have been found to rarely improve access to health care or quality, and they don’t reduce prices. But the system in place to stop them has limited powers. The reality is that the Federal Trade Commission’s (FTC) reach is limited when it comes to nonprofits, which most hospitals are. While the FTC can oppose anticompetitive mergers involving nonprofits, it cannot enforce action against them for anticompetitive behavior. So if a merger goes through, the FTC has limited authority.
Hospice News: (9/2) – Value-based care programs could be bridges closing gaps to accessing hospice care among underserved populations. Several hospices are honing in on expanding diversity, equity and inclusion efforts, as the pandemic further illuminates disparities in the U.S. healthcare system, often based on race or socio-economic factors. Moving toward value-based care could effectively transform the hospice payment landscape, which historically has depended on the Medicare Hospice Benefit.
Fierce Healthcare: (9/2) – A key Medicare advisory panel is debating one-time funding boosts to providers for 2023 due to questions on how COVID-19 has permanently impacted the healthcare industry. The Medicare Payment Advisory Commission (MedPAC), which gives Congress advice on Medicare payment issues, discussed during its meeting how the pandemic will affect payment adequacy in 2023 as members of the panel were concerned about what the healthcare industry will look like that far out, especially for providers.