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News Clips
PAI (4/4) PAI-Avalere Report: Rural Areas Face Steep Decline in Independent Physicians and Practices – Rural areas in the United States are quickly losing independent physicians and medical practices as corporate influence in health care grows, according to new PAI and Avalere research. Building upon previous analysis of national physician employment and practice ownership data, this new report provides a closer look at the physician practice landscape and health care corporatization in rural America. Between January 1, 2019, and January 1, 2024, the number of independent physicians fell sharply, declining 43 percent. More than 40 percent of independent medical practices closed or were acquired by hospitals, health systems and other corporate entities like health insurer-affiliated owners and private equity groups.
Avalere (4/9) Analysis of CMMI Model Costs, Quality Performance, and Transparency – Avalere found CMMI models, in aggregate, are not generating direct savings to Medicare. However, select models were effective at reducing net costs and offer specific positive indications for CMMI’s ability to generate savings in future models. Of the 18 models analyzed: one-third of the models yielded substantial net savings for the federal government; one-third of the models generated substantial net losses; and one-third of the models had nominal financial impacts as of their latest evaluation report. There were measurable improvements in quality measures across several CMMI models, although there was little-to-no impact reflected in patient experience surveys and, where available, there were mixed results in outcomes across patient demographics.
Modern Healthcare (4/11) How ACOs think CMS should change the rules for value-based care – The industry seeks a refreshed strategy from CMS, or at least a signal of what its priorities are. The administration hasn’t done much proactive Medicare policymaking to date, but the Center for Medicare and Medicaid Innovation terminated four payment models last month and announced it would unveil a new plan at a later date. The agency did not respond to questions about what it might do or when. ACOs and value-based care advocates think it’s critical to both long-standing and new participants to offer a stable financial model. Overall, maintaining steady value-based care programs such as the fee-for-service Medicare Shared Savings Program makes joining the arrangements more attractive. ACOs and value-based care providers are also asking CMS to reduce the administrative burden to participate in its payment models.
Physicians Practice (4/11) What the Trump tariffs mean for independent practices – Tariffs have the potential to have a very serious negative impact on all practices, not just independent practices. While larger health systems may be better equipped to absorb cost increases, independent physicians will feel the effects more acutely. Any penny that a physician spends is a penny that comes out of his or her practice. Expect to see rising prices on medications, supplies, and equipment, especially when those items are sourced from overseas or not produced in high enough volumes domestically.
Healthcare Innovation (4/14) Maryland Stakeholders Express Hopes, Concerns About AHEAD Model – Next year the State of Maryland will transition from its unique Total Cost of Care (TCOC) payment model to the CMS AHEAD model. The state’s Health Services Cost Review Commission (HSCRC) recently heard testimony from a variety of stakeholders about their hopes and concerns for AHEAD. The AHEAD Model will provide participating states with funding and other tools to address rising healthcare costs and support health equity. But the model also holds states accountable for state-specific Medicare and all-payer cost growth and primary care investment targets, and for population health and health equity outcomes.
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