PEPC Responds to HHS Primary Care RFI

The Department of Health and Human Services (HHS) recently released a Request for Information (RFI) on strengthening primary health care in the United States. PEPC appreciates HHS’ recognition that high-quality primary health care is essential to improving health equity and health outcomes, and believes that the adoption of value-based care models is critical to realizing our collective vision for primary care. Our response focuses on the role of independent physicians and practices in providing high-value primary care services to communities across the country through value-based care models.

To read the full response, click here.

Administration News

HHS: (8/8) – Health Resources and Services Administration (HRSA) awarded nearly $90 million in American Rescue Plan funding to nearly 1,400 community health centers across the country to advance health equity through better data collection and reporting. The funding will support a data modernization effort aimed at better identifying and responding to the specific needs of patients and communities through improved data quality, advancing COVID-19 response, mitigation and recovery efforts, and helping prepare for future public health emergencies.

HHS: (8/8) – HRSA announced investments of nearly $60 million to grow the health workforce and increase access to quality health care in rural communities, including nearly $46 million in funding from the American Rescue Plan. The funding will help to expand health care capacity in rural and tribal communities through job development, training and placement, and will establish new medical residency programs in rural communities.

Health Affairs: (8/8) – CMS officials published a blog examining the lessons learned to date from the Accountable Health Communities (AHC) Model test, which launched in 2017 and ended in April 2022. The blog is centered around key evaluation findings and promising practices that providers and payers can implement to address health-related social needs (HRSNs) in their patient populations and communities. The article also describes emerging themes for how AHC Model participants plan to scale and sustain the model interventions and how lessons learned are being embedded across CMS.

CMS: (8/5) – CMS approved strategies under section 1902(e)(14)(A) of the Social Security Act to support states facing operational issues with income and eligibility determination systems and to protect eligible beneficiaries from inappropriate coverage losses following the end of the COVID-19 Public Health Emergency (PHE).

HHS: (8/4) – HHS Secretary Becerra declared the ongoing spread of monkeypox virus in the United States a Public Health Emergency (PHE), allowing the Biden Administration to expand the availability of vaccines, testing, and treatment nationwide.

HHS: (8/3) – HHS released two reports intended to outline an action plan to address Long COVID and associated symptoms. The National Research Action Plan on Long COVID report details advances in current research and charts a course for future study to better understand prevention and treatment of Long COVID. The Services and Supports for Longer-Term Impacts of COVID-19 report highlights resources for health care workers, and those affected by broader effects of COVID-19.

White House: (8/3) – President Biden signed an Executive Order (EO), Securing Access to Reproductive and Other Healthcare Services. This EO directs the Administration to take further action to protect access to reproductive health care services and to address women’s health and public health issues more broadly.

Legislative News

Inflation Reduction Act of 2022: (8/7) - The Senate passed the Inflation Reduction Act of 2022 (H.R. 5376) by a vote of 51-50. The bill provides funding, establishes programs, and otherwise modifies provisions related to education, labor, child care, health care, taxes, immigration, and the environment. Notably, the legislation allows Medicare to negotiate drug prices, caps Medicare drug out-of-pocket costs to $2,000, and extends the American Rescue Plan enhanced ACA premium tax credits for three years (through 2025). Bill Summary

Member News

AAFP: (8/3) - The American Academy of Family Physicians (AAFP) submitted comments to HHS in response to a recent request for information on strengthening primary care in the United States. In its letter, AAFP called for a number of regulatory actions to improve patient access to comprehensive primary care, strengthen the primary care pipeline and reduce family physicians’ administrative complexity.

MGMA: (8/2) - Medical Group Management Association (MGMA) wrote an advocacy letter to HHS’ Secretary Becerra and CMS’ Administrator Brooks-LaSure, urging them to to continue utilizing HHS’ enforcement discretion and provide medical group practices with at least six months final notice prior to the enforcement of any additional surprise billing requirements.

News Clips

The Hill: (8/6) – This opinion piece by Sylvestor Turner, Mayor of Houston, notes America’s mayors are enthusiastic champions of public-private partnerships in the quest for healthier communities and greater equity, but require support from the federal government. He argues that while there is a dispute in the Democratic party regarding whether a market-based approach or a nationalized system is the solution to achieve universal health care, we must continue to support value-based care models from CMMI that encourage preventative care, help keep patients out of the emergency room, and incentivize coordinated care and better outcomes.

Urban Institute: (8/4) – This brief provides key insights from a panel discussion, “Accounting for Social Risk in Value-Based Payment and Quality Measurement,” which the Urban Institute convened on April 27, 2022. The panel included 13 national experts on value-based payment, risk adjustment, quality measurement, and health equity. The brief presents background material and summarizes panelist comments about the need to consider social risk in value-based payments and quality measurement.

Medical Economics: (8/3) – This article discusses an April 2022 study that examined geographic trends of private equity (PE) acquisitions of physician offices specializing in dermatology, gastroenterology, ophthalmology, obstetrics/gynecology (OB/GYN), orthopedics, and urology. The authors found that, as of 2019, less than 10 percent of physicians worked in PE-acquired practice. PE penetration was greatest in the Northeast, with D.C. having the highest rate at over 18 percent, and lowest in the Midwest.

Urology: (8/2) – This study examined the implications of MIPS for urology practices of different sizes and found that small urology practices and those caring for a higher proportion of dual eligible beneficiaries tended to perform worse in MIPS and were significantly less likely to receive bonus payments.

National Law Review: (8/2) – This article discusses the complexity of value-based payments capturing qualitative ideas, such as “quality,” “value,” and “equity,” into quantitative measures. The authors provide an overview of two key components of value-based arrangements that are especially complex and prone to disputes: benchmarking and data sharing rights.

Cato Institute: (7/19) – The authors of this briefing paper argue that to improve health care quality and reduce health care prices, state and federal legislators need to drastically overhaul or repeal regulations, tax distortions, and entitlement programs that encourage producers to consolidate.

Events

August

• August 11 - CMS, “Quality Programs Bi-Monthly Forum.” Virtual.
• August 11 - CMS, “Strategic Roadmap for Advancing Digital Quality Measurement.” Virtual.

September

• September 7-9 - National Association of ACOs, “Fall 2022 Conference.” Virtual.
• September 19-21 - AAFP, “AAFP Congress of Delegates.” Washington, DC.
• September 29-30 - World Conference Forum, “2022 Value Based Healthcare Forum.” Las Vegas, NV.

October

• October 6 - California Medical Association, “NEPO Summit: Beyond Unconscious Bias to Health Care Equity.” Virtual.
• October 9-12 - MGMA, “Medical Practice Excellence: Leaders Conference.” Boston, MA.

November

• November 8 - California Medical Association, “Webinar - CMS Medicare Updates 2023.” Virtual.

January

• January 23-27, 2023 - Health Care Value Week, “Value Week 2023.” Virtual.

If you would like your event to be included in the next newsletter, please email kristen@physiciansforvalue.org.