It’s clear that the Biden administration believes the federal government should play a more active role in addressing the pandemic. This is the case in its hard push to manufacture hundreds of millions of vaccines for Americans in just a few months and FEMA’s support in opening and supporting mass vaccination sites around the country. Now the administration is getting into the vaccine education business itself and inviting both national and local leaders to join them.
POLITICO reported that the administration plans to announce a sweeping new campaign to reduce vaccine hesitancy in early April. The PCC and many of our members have contributed to these efforts. The campaign will focus on reaching Americans who are skeptical of signing up for a shot or who don’t know where to get it; it also aims to combat misinformation about the vaccine’s efficacy and safety.
Vaccine mistrust and misinformation seem to spread as easily as COVID itself. Both mask wearing and the vaccines have become politicized. But thankfully there are now many communication campaigns, both sweeping and focused, that can counteract the mistrust and misinformation.
While primary care has largely been left out of the vaccination effort to date – an issue that we are also in dialogue with the White House about – we know from recent COVID and primary care surveys with the Larry A. Green Center that many primary care practices are engaging their patients on the vaccine. Over 60% of clinicians surveyed have already created eligibility groups and proactive outreach campaigns to educate their patients. And 73% also say they have noticed their relationship with patients has been key to helping with address vaccine hesitancy.
The federal government has the ability to undertake a massive vaccine education campaign. But primary care clinicians have the trust of their patients – a valuable asset that the administration should also leverage.
Sincerely,
You're Invited:
Release and Briefing on PCC's New Report:
Innovations in Oral Health and Primary Care Integration
Oral health is health. Yet for at least one-third of Americans, dental care is unreachable due to lack of access. Further, COVID-19 has exacerbated economic and racial inequities in health and dental care. These inequities most directly impact groups that have endured and continue to face racism and injustice. The integration of oral health and primary care is increasingly acknowledged as a key strategy to achieve health justice.
The PCC will host an online briefing to share the findings of its new report:
Innovations in Oral Health and Primary Care Integration
The report provides a comprehensive look at the critical need to integrate oral health and primary care and showcases the multitude of ways that primary care clinicians, community, and public health leaders are working together across the country to make it happen.
Join us for a panel discussion where we will walk through the key findings of the report, innovative models already enabling patients to thrive, and guidance for clinicians, health plans and policymakers to enhance oral health integration and primary care.
About the briefing:
Primary care and oral health experts will provide an overview of the report and highlight important findings.
Leaders of healthcare organizations will share how they have successfully integrated oral health and primary care.
A panel of experts will provide analysis and insights on the future of integration.
Time will be allotted for audience questions of all panelists.
Speakers:
Ann Greiner, MCP, President and CEO, Primary Care Collaborative
Darilyn Moyer, MD, CEO, American College of Physicians
Myechia Minter-Jordan, MD, MBA, President and CEO, DentaQuest Partnership for Oral Health Advancement
Anita Glicken, MSW, Executive Director, National Interprofessional Initiative on Oral Health (report advisory group chair and report contributor)
Lisa Simon, MD, DMD, Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine (adviser and report contributor)
Amit Acharya, PhD, Former Executive Director, Marshfield Clinic Research Institute, a division of Marshfield Clinic, an integrated healthcare system with more than 50 locations in Wisconsin
Michael Helgeson, DDS, MBA, Chief Executive Officer, Apple Tree Dental, which operates eight centers for dental health in Minnesota
Cheryl Fish-Parcham, MSW, Director of Access Initiatives, Families USA
The Biden-Harris administration has appointed several officials to health policy positions that may impact primary care. These include Xavier Becerra, who was confirmed as the first Latino Secretary of the Department of Health and Human Services, and Rachel Levine, who was confirmed as Assistant Secretary for Health in HHS and is the first openly transgender federal official confirmed by the Senate. Vivek Murthy, the former Surgeon General under Barack Obama, was re-confirmed to fill the role again. Read PCC’s letter of support for him that asserts he brings experience, vision and evidence-based sensibility to help the country through the COVID-19 pandemic and beyond. Elizabeth Fowler, most recently of the Commonwealth Fund and a former PCC board member, was selected to lead the Center for Medicare and Medicaid Innovation (CMMI). Biden named Chiquita Brooks-LaSure, a former federal policy official now with Manatt Health, as his nominee for CMS Administrator.
CMS Payment Model Updates & Deadlines
The Centers for Medicare and Medicaid Services (CMS) recently released the Request for Applications for the second cohort of Primary Care First (PCF), which is open to all practices in the 26 regions, not just those in the Comprehensive Primary Care Plus (CPC+) program ending this year. Practices should apply by April 30 and payers by May 28. The Seriously Ill Population component of the PCF model is currently under review. The Geographic Direct Contracting Model known as “Geo” is also on hold while being reviewed. CMS announced that ACOs should submit a Notice of Intent to Apply (NOIA) by June 7 at 12 p.m. ET in order to apply for a January 1, 2022, start date for the Medicare Shared Savings Program.
Reimbursement for COVID-19 Vaccine Administration Nearly Doubled
On March 15, CMS announced that it was increasing the Medicare payment for administering COVID-19 vaccines to an average of $40 per dose, up from the previous averages of $28.39 for single-dose vaccines; and $16.94 (1st dose), then $28.39 (2nd dose) for two-dose vaccines. (The exact payment rate depends on the type of entity furnishing the service and geographic adjustments.) And the American Rescue Plan mandated that the federal government now fully cover COVID-19 shots for Medicaid and CHIP beneficiaries. Patients continue to receive COVID-19 vaccines for free—regardless of health coverage type/status—with no applicable copayment, coinsurance or deductible.
Health Disparities and COVID
The Department for Health and Human Services recently released a new issue brief describing health disparities by race and ethnicity during the COVID-19 pandemic, with findings showing disparities in testing, infections and hospitalizations. COVID-associated death rates were considerably higher among American Indian/Alaska Native, Black and Hispanic persons compared to White persons. Mid-month, the Biden administration announced that it was investing $250 million to encourage COVID-19 vaccination among underserved populations. And an analysis by the Kaiser Family Foundation found that community health centers were successfully reaching people of color in their early vaccination efforts.
Bill Introduced on Medicaid Payment Parity for Primary Care
H.R. 1025, the “Kids’ Access to Primary Care Act of 2021,” calls for Medicaid to pay primary care no less than Medicare as a way to ensure better access to essential services for vulnerable populations. Previously, the Affordable Care Act had mandated a two-year increase in Medicaid primary care payments to Medicare levels for 2013 and 2014, though it was not reauthorized. PCC submitted a letter of support for H.R. 1025 to be part of the record for the Energy and Commerce Subcommittee on Health’s March 23 hearing on “Building on the ACA: Legislation to Expand Health Coverage and Lower Costs," which included the Kids’ Access to Primary Care Act.
Proposed Legislation Impacting Primary Care
Congress has introduced several bills impacting primary care since the start of the year. These include:
the Veterans Access to Direct Primary Care (H.R. 1520), introduced by Reps. Chip Roy (R-Texas-21), Madison Cawthorn (R-N.C.-11), Ted Budd (R-N.C.-13), John Curtis (R-Utah-3), and Pete Sessions (R-Texas-17), that would pilot a program providing health savings accounts to veterans, allowing them to receive care through direct primary care arrangements outside of the Veterans Administration
the TREAT Act, introduced by Sens. Chris Murphy (D-CT) and Roy Blunt (R-Mo.) and Reps. Bob Latta (R-Ohio-5) and Debbie Dingell (D-Mich.-12), provides temporary state licensing reciprocity for all licensed/certified professionals to deliver in-person and telehealth care during the COVID-19 Public Health Emergency
H.R. 1025, Reps. Kim Schrier (D-Wash.-8), Kathy Castor (D-Fla.-14), and Brian Fitzpatrick (R-Pa.-1), would reapply the Medicare payment rate floor to primary care services provided under Medicaid.
Latest COVID Relief Package’s Implications for Primary Care
The latest COVID-relief bill passed by Congress, the American Rescue Plan Act of 2021, includes a range of economic and public health support measures, many of which have implications for patients and primary care practices. The package significantly expands access to health coverage through substantial subsidies for Affordable Care Act plans, as well as COBRA subsidies for the unemployed, and funding to incentivize Medicaid expansion in the 12 states that have not yet pursued it. The act also includes $7.6 billion to expand the public health workforce and $800 million for the National Health Service Corps, along with funding for teaching health centers. The relief package allocated $10 billion for rural health care providers to pay for unexpected expenses related to the pandemic. It also recognizes the toll of the pandemic on the mental health of Americans and included policies and funding to address their needs, including $40 million to HRSA to specifically address the mental health needs of healthcare professionals. No additional funds were allocated to the Provider Relief Fund, apart from targeted money for rural hospitals, and the loan terms of the Medicare Advanced Payment program were not relaxed.
ACA Open Enrollment Extended, Medicaid Work Requirements
The most recent COVID-19-related stimulus package included substantial subsidies for healthcare coverage (see above). It builds on the several healthcare-related executive orders Pres. Biden signed within his first weeks office, including one on Strengthening Medicaid and the Affordable Care Act. The Department of Health and Human Services announced a special enrollment period for uninsured and underinsured individuals to access coverage through the Federal Marketplace between February 15 and May 15, along with $50 million for an outreach campaign. Just last week, the administration announced it would extend the open enrollment period by three more months, allowing more Americans time to sign up for health coverage using the subsidies included in the American Rescue Plan passed by Congress earlier in March. The executive order also called for the immediate review of agency actions under President Trump, with the Biden administration recently notifying states that it is withdrawing approvals for Medicaid work requirements.
Executive Member Spotlight: PCC Pediatric EHR Solutions
PCC Pediatric EHR Solutions (“PCC” in this article) has been a Primary Care Collaborative Executive Member since March 2015. Not to be confused with the Primary Care Collaborative (also called “PCC”), PCC is a Vermont-based benefit corporation founded in 1983 with the mission to remove the obstacles that prevent pediatricians from caring for children.
PCC produces and supports an award-winning electronic health records (EHR) system designed specifically for the unique requirements of pediatricians. PCC is a consultant to independent pediatric practices throughout the country and speaks frequently to AAP chapters, children’s hospitals, and others in the primary care community. PCC hosts and produces a wide variety of pediatric content, from The Independent Pediatrician magazine to the Pediatric Supergroup conference.
PCC has played important roles with the AAP, CCHIT, the CDC, the Children’s Electronic Health Record Format, Protecting Privacy to Promote Interoperability (PP2PI), and ONC to address gaps and improvements in pediatric IT development and EHR certification.
As fierce advocates of the Patient-Centered Medical Home (PCMH), as well as the AAP’s Bright Futures guidelines, PCC has tailored its software and services to promote preventive care at every turn. Nearly 50% of PCC practices have been PCMH-recognized.
Some of PCC’s most important work is sharing pediatric clinical and financial performance data. In April 2020, PCC produced a public COVID-19 dashboard to track the business impact of COVID on independent practices. Later in the summer, PCC’s data about the impact of COVID on immunization rates, depression screening, and other pediatric PCMH facets was shared with the New York Times, Wall Street Journal, and many national and local TV outlets.
PCC is perhaps most known for the “Business Impact Webinar Series” that Director of Pediatric Solutions, Chip Hart, co-hosted with Paul Vanchiere of PMI last year. From April through September 2020, Chip and Paul delivered a 2- to 3-hour weekly webinar featuring some of the most important practice management and pediatric voices in the country. At its peak, more than 1,600 pediatricians and their staff tuned in live, and more than 3,500 joined the web forum almost overnight. With guest speakers including Mark Del Monte (AAP CEO/EVP) and Dr. Moira Szilagy (AAP President), pediatricians around the country depended on the webinar to keep them informed and keep their practices open. The forum and webinar have evolved to address post-COVID topics vital to practicing pediatricians.
PCC is grateful to the Primary Care Collaborative for its important role in advocating for the PCMH and preventive care. The PCMH is the connection that brought PCC and the Primary Care Collaborative together and the PCC into the (other) PCC’s membership.
I Am a Primary Care Champion
This is a regular feature of PCC’s newsletter. Each issue features a short profile of an individual who works in primary care. It is a way of recognizing the dedication and passion that clinicians, advocates, and others have for primary care and connecting readers of this newsletter to people like them.
Julie Schilz, BSN, MBA
Director, Health Program Improvement at Mathematica
Why are you passionate about primary care?
As a nurse, I learned early in my career that we had a healthcare system that was failing to deliver on health, and I found this to be unacceptable. Primary care is the solution to creating a healthy and equitable healthcare system. Barbara Starfield’s core functions of Primary Care – first Contact accessibility, Coordination, Comprehensiveness, and Continuity – remind us why this is true.
If you had a magic wand that you could wave to change one thing in primary care, what would it be?
I would address the instability in payment methods to primary care. I would make the right thing for patients, their families and communities the easy thing by investing in primary care. I would stabilize the payment methods for primary care to deliver integrated, accessible health services.
What one thing about your work do you want people working outside primary care to know or understand?
We have known for a very long time through research that access to advanced primary care can help people live longer, healthier lives and that strong primary care can reduce unnecessary healthcare costs that impact our economy. As highlighted by the pandemic, we also know that we have an inequitable healthcare delivery system. We have been reminded that a strong foundation of primary care can reduce the disparities in the delivery of health and health care and bring better health, better care and lower costs.
Looking back on your career, what’s the most significant contribution to primary care that you or your team have made?
It takes a village. Contributions to primary care have happened when committed people come together. I have had the opportunity to work with such people to support primary care locally, regionally and nationally through Patient-Centered Medical Home (PCMH), value-based payment models, primary care-focused transformation models such as the Chronic Care Model, and the development of the Shared Principles of Primary Care. Primary care and the practice teams are driven to provide the best for their patients and families. Having the opportunity to engage with primary care practices, learn from them, support them, and continue to advocate for them has been an honor.
PCC's Thought Leadership
Reform of Payment for Primary Care in New England Journal of Medicine
In a Perspective article - "Reform of Payment for Primary Care — From Evolution to Revolution" - in The New England Journal of Medicine, Allan H. Goroll, MD; Ann Greiner, MCP, PCC's president and CEO; and Stephen C. Schoenbaum, MD, MPH, wrote about primary care's foundational role in a high-value health system. However, they explain, the United States has seen troubling declines in practices’ financial viability. How best to pay for primary care, how much to pay, and how rapidly change needs to occur are urgent questions, they write.
Leaders of PCC and PBGH Write About Primary Care in STAT
“Building back better requires strengthening primary care” is an opinion article co-authored by Ann Greiner, PCC’s president and CEO, and Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health, a PCC Executive Member. The article was published in First Opinion on STAT on March 26.
“As the pandemic enters its second year, the health care workers who care for patients with Covid-19 and other serious conditions deserve our gratitude and support. Many on the frontlines are not just tired but are also in precarious financial straits and lack the resources to ‘build back better,’” write the co-authors. “This is a dangerous place for the country. A key response to the pandemic is fundamental reform in how we pay — and how much we pay — primary care providers.”
Journal Articles on Primary Care's Key Role in Closing Care Gaps for Women
The PCC, along with a number of its Executive Members and members of the Bridging the Chasm Collaborative, released a women-first agenda on March 8. This agenda closes the healthcare gaps that contribute to preventable maternal deaths and chronic illness later in life among all women, especially Black, Indigenous, and other women of color. PCC believes that primary care can play a key role in closing care gaps often evident in the year after women give birth but that can affect them for a lifetime.
The agenda is presented in two articles published in the journal Women’s Health Issues:
Ann Greiner, PCC’s president and CEO, was a contributing author to the two articles.
The agenda comes as Congress considers legislation to tackle huge racial inequities in maternal health with the 2021 Black Maternal Health Momnibus Act.
The broad coalition of clinicians, researchers and advocates that formulated the agenda includes PCC members - Black Women’s Health Imperative, Mathematica, Johns Hopkins Community Physicians - and is led by the Boston University Schools of Public Health and Medicine.
“Many women, especially women of color, fall into a healthcare chasm after they give birth. That gap is a major factor in preventable deaths and chronic illness for these women,” said Ann Greiner, PCC’s president and CEO and a contributing author to the journal articles. “Primary care can step into that gap and provide the care that these mothers need after giving birth and stave off pregnancy-related conditions that can affect them for a lifetime. Providing such care can address fragmentation and improve healthcare equity.”
The journal articles present remedies to the structural chasms in women's health care, with key roles for advocates, policymakers, researchers, healthcare leaders, educators, and the media.
March 22, 2021
An Urban Institute survey during the pandemic showed that more than one in three U.S. adults – most with chronic conditions – delayed getting treatment, either over fear of the virus or because of COVID-19-related limits on services. Even as the public health emergency continues, studies are raising alarm about missed care in primary care, behavioral health, and dental care and within specific minority communities. What are the implications for individual patients – adults and children – and populations from forgoing regular checkups, preventive screenings and routine vaccinations? How can primary care address this potential new crisis while also helping to bring the COVID-19 emergency to an end? In this webinar, a panel of experts from a range of areas address these questions and more.
Panelists:
Deana Baptiste, MPH, PhD, Director, Guideline Development Process | American Cancer Society
Mark Talluto, Vice President, Strategy and Analytics | BlueCross BlueShield Association
Magdala Chery, MBS, DO | Commonwealth Fund Fellow in Minority Health Policy at Harvard University
February 23, 2021
As millions of people across the country roll up their sleeves to receive COVID-19 shots, many sectors are also rolling up their sleeves and getting to work in this massive undertaking. Primary care has very much been in the mix—answering patient questions, helping to overcome vaccine hesitancy and beginning to administer the vaccines. We have the experience, assets and skills to help meet the country’s vaccine goals. But for widespread immunity to happen rapidly and efficiently, it will take coordination and cooperation by primary care and other sectors. And there are many challenges, requirements and considerations, from patient concerns about the vaccine, to differences in vaccine effectiveness, to data collection and sharing, and more recently, issues related to virus mutations. In this webinar, four experts provide different perspectives on the role of primary care and other sectors as the distribution of the vaccines ramps up.
Panelists:
Darilyn V. Moyer, MD, FACP, FRCP, FIDSA, Executive Vice President & Chief Executive Officer | American College of Physicians
Angelica Geter, DrPH, MPH, Chief Strategy Officer | Black Women's Health Imperative
David Fairchild, MD, MPH, Medical Officer, CVS MinuteClinic; Professor of Medicine, University of Massachusetts Medical School
Lloyd Michener, MD | Professor of Community and Family Medicine, Duke University School of Medicine
Moderator: Ann Greiner, President and CEO | Primary Care Collaborative
January 25, 2021
In its broadest look yet at primary care spending, the PCC analyzed spending over time, nationally and in all 50 states, and published the results in its annual evidence-based report for 2020 (released December 2020). The report reveals some alarming trends: The U.S. health system’s investment in primary care is low and declined between 2017 and 2019, both nationally and in a majority of states. The findings of the report, Primary Care Spending: High Stakes, Low Investment, are concerning given that a growing body of literature shows that health systems with a foundation of robust, comprehensive primary care achieve better, more equitable health outcomes and are less costly. This webinar walks through the findings of the report, and then two experts—one from the health plan perspective and another from the state health policy perspective—discuss how federal and state policymakers might leverage these results to enhance primary care investment.
Presenter: Ann Kempski, adviser and lead author of report | Primary Care Collaborative
Panelists/reactions:
Connie Hwang, MD, MPH, Chief Medical Officer & Director, Clinical Innovation | Alliance of Community Health Plans
Maureen Hensley-Quinn, Senior Program Director of Emerging Policy Issues | National Academy for State Health Policy
Moderator: Ann Greiner, President and CEO | Primary Care Collaborative
Bipartisan Policy Center to Release New Report on Integration of Behavioral Health and Primary Care
Register for the March 31 Online Report Release and Briefing
In addition to the PCC’s new report on the integration of oral health and primary care, which will be released tomorrow (March 31) at an online briefing, the Bipartisan Policy Center (BPC) is also releasing a new report on the same day on the integration with primary care of another critical area: behavioral health.
The report is produced by the BPC’s Behavioral Health Integration Task Force, which invites the public to attend its online release event, Wednesday, March 31, 11:30 a.m.-12:45 p.m. ET. (immediately following the release of PCC’s new report).
The report’s recommendations for advancing behavioral health and primary care address barriers through improving payment delivery, expanding and training the behavioral health workforce, and removing obstacles to telehealth and technology. Among those contributing to the report were Mental Health America, a PCC Executive Member.
Included in the event are members of the task force: Regina Benjamin, MD, 18th U.S. Surgeon General; Founder and CEO, Bayou Clinic, Inc.; Richard G. Frank, PhD, Margaret T. Morris Professor of Health Economics, Harvard University; Patrick Kennedy, Former U.S. Representative; Founder, The Kennedy Forum; and John. E. Sununu, Former U.S. Senator.
Upcoming Conferences, Webinars & Events
PCC's Online Event Calendar These and other webinars and conferences are listed on PCC's event calendar on its website. Updated regularly, the calendar lists events of interest to the primary care community.
Integrating Care Through a Biopsychosocial Approach to Health
The Primary Care Development Corporation, in collaboration the SAMHSA Center of Excellence for Integrated Health Solutions, is engaging in a year-long virtual initiative focused on addressing sleep and related social and health needs through enhancing integrated primary and behavioral health care. This initiative will include live virtual learning opportunities, free tools and resources, and linkage to experts in the field. An anchor for the year will be a monthly webinar series focused on building foundations and advanced applications of sleep knowledge. Webinar sessions are 60 minutes each with a follow-on open "office hour" for Q&A with experts.
Remaining webinars:
All are 1:00-2:30 p.m. ET on the days indicated
Physical Health and Primary Care Lens on Sleep: Assessment and Intervention | April 1, 2021
What about Us? A Discussion with and for Healthcare Providers | May 6, 2021
GTMRx Institute and Bipartisan Policy Center (BPC) Virtual Event
April 6, 10:30 a.m.-noon EDT
Discussion of effective strategies to build vaccine confidence during the COVID-19 pandemic. During this event, GTMRx will announce the National Task Force: Building Vaccine Confidence in the Medical Neighborhood. To achieve widespread vaccination of Americans against COVID-19, engagement of the medical neighborhood is fundamental when implementing community programs designed to effectively build vaccine confidence. Building vaccine confidence requires proactive and thoughtful public awareness, education and engagement of a variety of local stakeholders including community members.
April 21, 11:00 a.m.-5:00 p.m. ET
This event will be a culmination of a four-part webinar series in March by the Association of State and Territorial Health Officials that shared perspectives on the national, organizational, and policy-level shifts needed to transform public health and advance health equity. This half-day virtual summit, hosted in partnership with CDC’s Office of Minority Health and Health Equity and the Robert Wood Johnson Foundation, will provide a forum for state and territorial health practitioners and primary care to learn about emergent public health issues and apply evidence-based practices to address structural racism and reduce racial and ethnic disparities. The convening will highlight real-world case examples from the field that can be applied to current public health challenges.
New brief from the U.S. Dept. of Health & Human Services
The COVID-19 pandemic has highlighted stark health disparities among Black, Hispanic, Native American, and Native Hawaiian/Pacific Islander populations in several areas, including infections, hospitalizations, death rates, and vaccination rates. This issue brief describes current evidence related to COVID-19-related health disparities and includes potential policy solutions to improve health equity.
Published March 2021
Using data from 84,419 respondents in the 2015-18 California Health Interview Survey, we assessed the association between limited English proficiency and telehealth use (telephone and video visits) and evaluated the impact of telehealth use on healthcare access and use. This study suggests that policy makers and clinicians must focus on limited English proficiency as an important dimension to promote telehealth equity and decrease digital divides.
Findings from a Feb. 2021 survey of 3,000 Americans about their physical and behavioral health by the American Psychological Association
Why You Should be a PCC Executive Member
Executive Membership in PCC comes with many benefits. Becoming an Executive Member allows you to:
Connect and network with organizations and individuals from different stakeholder groups who share a common commitment to furthering primary care
Contribute to the PCC’s policy and advocacy work
Receive the monthly member-only e-newsletter that highlights policy developments, upcoming events, and key issues related to primary care
Join and become an active participant in PCC's four workgroups
Receive discounts on event registrations
Sponsor events and initiatives
Do much more
Visit the Executive Member pagefor more information, and watch the short (less than 2 minutes) videobelow that features organizations and why they chose to become Executive Members.
If you have questions about the membership process or benefits or would like to schedule a conversation about joining the PCC, please contact:
Julie Schilz, BSN, MBA
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