Welcome to this week's edition of the 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.
HHS: (4/19) - HHS announced the availability of nearly $150 million to community-based health care providers to aid their response to COVID-19. These funds will support nearly 100 Health Center Program look-alikes to respond to and mitigate the spread of COVID, strengthen vaccination efforts, and enhance health care services and infrastructure in communities across the country.
White House: (4/16) - President Biden announced a $1.7 billion investment to fight COVID-19 variants. The announcement includes $1 billion to CDC, states, and other jurisdictions to expand genomic sequencing, $400 million to support innovation initiatives including the launch of new innovative Centers of Excellence in Genomic Epidemiology, and $300 million to build and support a National Bioinformatics Infrastructure. The first tranche of funding will be distributed in early May. A second tranche of funding will be invested over the next several years.
HHS: (4/15) - HHS Secretary Xavier Becerra renewed the COVID-19 Public Health Emergency declaration. Assuming a full 90-day declaration, the PHE should extend through July 14, 2021 and make the CARES Act 6.2 percentage point FMAP enhancement available through Q3 of 2021.
OIG: (4/15) - HHS Office of Inspector General (OIG) released a statement reminding vaccine providers and the public that the COVID-19 vaccine must be administered at no cost to recipients.
GAO: (4/14) - The U.S. Government Accountability Office (GAO) issued a report on efforts to increase vaccine availability and perspectives on initial implementation. GAO found that manufacturing and distribution must increase significantly to make enough doses available for all adults, and Associations representing state and local health officials reported challenges such as not knowing how many doses they would get or when.
HHS: (4/13) - HHS published several new resources to help states, vaccination providers, and others leading COVID-19 response activities improve access to vaccines for people with disabilities and older adults. These resources clarify legal requirements, illustrate some of the barriers to vaccine access faced by people with disabilities and older people, and provide strategies – and examples of how the aging and disability network can help employ them – to ensure accessibility.
FDA: (4/13) - The CDC and FDA released a joint statement on the Johnson & Johnson (Janssen) vaccine, recommending a pause in the use of the vaccine after six reported U.S. cases of a rare and severe type of blood clot developed in individuals.
Choose Medicare Act: (4/15) - Sen. Merkley (D-OR) and 11 cosponsors introduced the Choose Medicare Act (S.1180), which would provide for the establishment of Medicare part E public health plans. Summary
H.R. 1868: (4/14) - President Biden signed into law H.R. 1868, which would extend a suspension of Medicare sequestration and make other technical changes to Medicare payments and Medicaid eligibility.
Comprehensive Care for Alzheimer’s Act: (4/14) - Reps. Higgins (D-NY), LaHood (R-IL), Tonko (D-NY) and Guthrie (R-KY) introduced the Comprehensive Care for Alzheimer’s Act (H.R.2517), which would recommend that the Center for Medicare and Medicaid Innovation test the effect of a dementia care management model. Sens. Stabenow (D-MI) and Capito (R-WV) introduced companion legislation in the Senate (S.1125).
Florida Medical Association: (4/20) - Mary Thomas, Esq., Assistant General Counsel at Florida Medical Association, wrote a paper on the Florida regulatory landscape and changes that could impact the practice of medicine during the current legislative session. The paper provides an overview of recent rulemaking activity and other developments FMA is tracking.
California Medical Association: (4/19) - The California Medical Association has partnered with Altais to develop technology and business solutions to promote the wellbeing and professional satisfaction of health care providers. CMA-affiliated independent practice physicians are invited to fill out a survey around provider needs and concerns during COVID-19.
Revcycle Intelligence: (4/16) - A group of health care industry groups, including Aledade, MGMA, and PEPC, wrote a letter to HHS Secretary Xavier Becerra calling on HHS to provide more full-risk accountable care organization (ACO) model options. The letter specifically calls out extending the Next Generation ACO Model through 2022 and creating a permanent full risk ACO option based on the Next Gen model for the future.
AAFP: (4/16) - In this article, faculty from the University of Colorado School of Medicine discussed the impact COVID-19 will continue to have on successful medical school graduate match rates for family medicine for years to come. The America Needs More Family Doctors: 25x2030 Collaborative, which is supported by AAFP and other national organizations, has set a goal to raise the percentage of US medical students who choose family medicine as their specialty from 12 percent to 25 percent by 2030.
AJMC: (4/20) - CMMI Director Liz Fowler gave her first public remarks at the opening plenary of the NAACOS Spring 2021 Conference, highlighting priorities for CMMI and next steps for models that have been paused or delayed. Fowler acknowledged that some CMMI models have been put on hold while the Innovation Center undergoes continued review, but that the commitment to value-based care is as strong as ever. She also emphasized that CMMI will prioritize health equity in every stage of CMMI’s models.
Health Affairs: (4/19) - As the health care system continues to shift toward value-based payment arrangements, there is growing concern that organizations caring for populations with greater social risk factors may be unfairly penalized. The authors of this blog, two current MedPAC Commissioners, propose two policy approaches to address this issue: 1) providing upfront supplemental payments to providers who care for higher-risk populations, and 2) adjusting performance incentive payments so those serving a larger population with greater social risk would receive larger rewards for an equivalent level of outcome.
Fierce Healthcare: (4/19) – The American Hospital Association (AHA) published a study reviewing claims from a five percent sample of Medicare beneficiaries who had at least one visit to an outpatient setting between January 1, 2012 and June 3, 2019. Findings suggest that Medicare patients who receive care in a hospital outpatient department are more likely to be poorer and have more severe chronic conditions compared to Medicare patients treated in an independent physician office. AHA used this study to reinforce its position against site neutral payments, claiming it could threaten access to care for vulnerable populations.
Health Affairs: (4/19) - The rise in specialist referrals and visits over the past several years has led to increased costs without evidence of significantly improved outcomes. This article proposes the following solutions for putting the primary care physician back at the center of providing care: 1) get the economic incentives right to reward primary care physicians for lowering costs and improving quality of care; 2) reform medical education to be re-oriented around primary care; 3) use Medicare Advantage more broadly; 4) expand the use of e-consults; and 5) refocus and repurpose continuing medical education.
Managed Healthcare Executive: (4/16) - Advocates for accountable care organizations (ACOs), such as NAACOS, are beginning to push for changes to bolster CMS’ ACO programs and encourage more risk taking within payment arrangements. Given the decrease in participants in the Medicare Shared Savings Program, NAACOs President and CEO Clif Gaus said making incentives to participate more attractive and the risks more manageable would lead more providers to participate.
Healthcare Finance News: (4/16) - Following the news that CMS would not be accepting new applicants for the Global and Professional Direct Contracting model, several provider groups through the America’s Physician Groups Direct Contracting Coalition sent a letter to CMMI Director Liz Fowler urging her to reconsider opening up another opportunity for prospective applicants to apply to the model. The groups who signed the letter viewed this announcement as a step backwards in the progress of the movement toward value-based care and a move that will impact potential participants who had made substantial investments to meet the requirements by the model start date.
Fierce Healthcare: (4/16) - According to the Medscape Physician Compensation Report 2021, physician salaries have rebounded despite the extreme volatility experienced as a result of the ongoing pandemic. The average salaries for primary care physicians stayed relatively constant at $242,000 from $243,000 the previous year. The report cited the pivot to telehealth, leveraging government recovery programs, and an increase in demand for services toward the end of 2020 as reasons behind this trend.
Milbank Memorial Fund: (4/15) - As states and payers continue to invest in primary care, many are employing strategies such as measuring primary care spending as a percentage of total health care costs and establishing benchmarks for increasing spending. To improve uniformity in defining primary care spend, this brief proposes a standard definition and measurement methodology to allow policymakers to quantify total investment in primary care and enable comparisons of spending across and within states, payers, and health care systems.
Managed Healthcare Executive: (4/14) - Leaders at the Leonard Davis Institute of Health Economics at the University of Pennsylvania have released recommendations to transform the health care system into one that focuses on value. Among suggestions include increasing the number of involuntary value-based programs, slowing down the introduction of new programs, and for CMS to favor programs with two-sided risk, among other recommendations.