Modern Healthcare: (5/31) - The pandemic led the way for virtual care to become more mainstream in the U.S., which could pose a threat to smaller practices that may not have made the transition to telehealth prior to the pandemic and therefore might not have the infrastructure to provide virtual care. A 2020 survey by Primary Care Collaborative and the Larry A. Green Center found that 6% of primary care physicians said their practices had closed and 35% said they had furloughed staff as a result of excess expenses, lower patient volume and a surge of non-traditional providers of primary care. Nearly 80% of respondents reported fewer patient visits during the pandemic compared to before. Sabrina Corlette, a research professor with Center on Health Insurance Reforms at Georgetown University McCourt School of Public Policy, said some traditional primary care providers see the rise of telehealth companies offering virtual services as a threat to their business model. Corlette said despite the potential for cost saving, she is wary of telehealth and virtual care companies marketing themselves to uninsured people as real coverage rather than a supplement to insurance if they only offer primary care services and not coverage for hospitalization, pharmaceuticals, medical emergencies and chronic diseases.
Effingham Daily News: (5/30) - The Illinois Rural Community Care Organization, LLC (IRCCO), a statewide Accountable Care Organization (ACO) to serve rural Illinois, announced it is partnering with Collaborative Health Systems, a management services organization, to expand value-based care in Illinois. Through the agreement, rural and critical access hospitals and providers have agreed to enter into a joint venture partnership with IRCCO and Collaborative Health Systems to help improve quality outcomes and lower health care costs for Medicare beneficiaries living in Illinois rural communities. IRCCO, a collaborative organization focused on delivering primary care, chronic disease management, care coordination and social services locally, was established in 2014 by the Illinois Critical Access Hospital Network (ICAHN), a trade association of critical access hospitals serving rural Illinois communities.
Healio: (5/28) - Researchers found no association between low-value services and patients’ ratings of their health care experiences, an analysis of Medicare claims showed. Patient experiences and ratings are often used “to incentivize quality improvement through public reporting and performance-based payments,” according to researchers. The widespread use of patient-reported health care experiences may “encourage physicians to provide more low-value services (care that is not associated with a clinical benefit), out of a belief that responding to patient demand or the perception that more care is better will improve their ratings,” Prachi Sanghavi, PhD, an assistant professor of biological sciences in the department of public health sciences at the University of Chicago, and colleagues wrote in JAMA Internal Medicine.
Health Payer Intelligence: (5/28) - Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Mission Health have signed an agreement that will expand the benefits of value-based care to members across Western North Carolina and increase access to care for Medicaid beneficiaries. Once the contract takes effect on January 1, 2022, Mission Health will join Blue Premier, Blue Cross NC’s value-based care program which ensures that providers are paid for the quality of care they provide, not the quantity. Blue Cross NC members in western North Carolina currently may receive care from six hospitals and over 1,000 physicians that are part of Mission Health’s system. This collaboration will provide members with high-quality, coordinated care that is more affordable, according to the press release.
PubMed: (5/27) - This paper investigates the consequences that patients face when their regular general practitioner (GP) closes down her practice, typically due to retirement. The study found that patients who experience a discontinuity of care persistently adjust their ambulatory utilization pattern by shifting visits away from GPs (-12%) toward specialists (+11%) and hospital outpatient facilities (+6%). These results have potential implications for health policy in that practice closures lead to more fragmented care which may entail inefficiencies, and closures deteriorate access to primary care in regions with low physician density.
Modern Healthcare: (5/27) - Some experts believe health systems may be using their post-COVID-19 publicity to pressure insurers into rate increases, pointing to a rash of recent tense negotiations erupting into the public sphere. Over the past 10 years, the number of payer and provider disputes that have gone public has decreased, as hospitals have consolidated their systems and strong-armed insurers into all-in-one contracts. The pandemic has stalled some negotiations as health care organizations try to gain back money lost from canceling elective procedures, while health insurers try to keep costs down. However, hospital systems may not have lost nearly as much as they anticipated during the pandemic. At the end of the year, sicker, commercially insured patients helped bump up hospitals' bottom lines and strategic cost-cutting measures helped trim down expenses. New price transparency rules will provide more insight into how contracts work out, although most major hospitals are still not posting their pricing. Greater insight into prices paid will make public perception of health systems an even more critical negotiation tactic going forward.
RevCycle Intelligence: (5/25) - CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15% to zero percent for the 2020 performance period to provide additional COVID-19 relief and account for the lack of reliable data. The MIPS cost performance category was originally weighted at 15%. Now, those points will be redistributed to other categories and will impact reimbursements paid out to eligible clinicians in 2022.
Fierce Healthcare: (5/24) - Physicians and consumers’ trust in the U.S. health care system dipped over the course of the COVID-19 pandemic, as did doctors’ trust in health care organization leadership, according to a recent survey. On the other hand, consumers’ trust in doctors themselves has generally held steady during the pandemic, and physician respondents often said their trust in nurses or fellow physicians had increased over the course of the public health emergency. For physician respondents, the decline in health care system trust was most prominent among those who already held a poor view of the system prior to COVID-19. The pandemic also had a net negative impact on physicians’ trust in health insurance companies and government health agencies, but slightly increased the overall sample’s faith in hospitals and pharmaceutical companies. The poll was conducted by NORC at the University of Chicago on behalf of the American Board of Internal Medicine Foundation. The research organization distributed its general public surveys to a sample of 2,069 adults between Dec. 29, 2020, and Jan. 26, 2021, and its physician survey to 600 clinicians between Jan. 22, 2021, and Feb. 5, 2021.
National Bureau of Economic Research: (May 2021) - The organizational structure of U.S. health care has changed dramatically in recent years, with nearly half of physicians now employed by hospitals. This trend toward increasing vertical alignment between physicians and hospitals may alter physician behavior relative to physicians remaining in independent or group practices. The authors found a relatively modest positive effects (point estimates of 7% or lower) on total Medicare payments per episode, characterized by an increase in billable activity among other integrated physicians alongside a large decrease in activity among non-integrated providers. Acquiring hospitals ultimately capture more revenue following a physician practice acquisition; yet, the smaller overall bundle of care generates no net savings to Medicare due to location-based payment rules favorable to hospitals.