November Month in Review 

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Message from the President and CEO
 
Dear Colleagues, 

In my recent travels, I have been struck by the variety and scope of strategies that employers, business coalitions and other purchasers are using to remove patient barriers to primary care and enhance value-based benefit design, while increasingly focusing on how care is delivered and paid for.  

With purchasers simultaneously pursuing multiple strategies – in a surround sound approach – this may more quickly propel efforts to achieve the quadruple aim.

Some leading purchasers – among them Covered California – offer plans that eliminate patient co-pays for primary and specialty care in ambulatory settings.  Covered California also requires all consumers in the CA exchange to select a PCP, and encourages Exchange Plans to increase the proportion of PCMHs they contract with and the proportion of contracted dollars in alternative payment arrangements.

Employers are also increasingly offering high deductible health plans (HDHP) paired with Health Savings Accounts (HSAs) – in 2017 more than a third offered HDHPs as the only plan option – to reduce costs and to provide incentives for consumers to select high value physicians, hospitals, and services.  Leading coalitions – including the Pacific Business Group on Health (PBGH) and Smarter Healthcare Coalition  – are advocating for regulatory and/or legislative changes that would expand the preventative care safe harbor.   Patients could then use tax-deductible HSA funds to cover services that prevent the onset, of or further complications related to, chronic conditions.  In short hand, this policy is known as an expanded primary care benefit for HDHP/HSAs. 

Employer groups are focused on shaping delivery and payment changes, as traditional cost control and benefit design changes are not sufficient to achieve sought after goals.  A three-year effort at the National Business Group on Health (NBGH) has resulted in a road map and scoring methodology that can guide employer efforts to promote ACO formation.  According to a recent NBGH survey, 21% of employers’ plan to promote ACOs in 2018.  The NBGH’s guidance is very clear that ACOs must be built on a strong primary care foundation, ideally a set of primary care practices that are PCMHs.    

A new cooperative of 40 plus innovative companies – The Health Transformation Alliance – has been quickly gaining steam and is focused on using data and analytics to inform a set of disruptive strategies that target the supply chain, including both medical and pharmaceutical organizations.  The HTA has set up an environment where these “suppliers” compete on the basis of value and performance to qualify for the right to provide care to the employees of the companies in the cooperative.   HTA companies believe that only by working together can they bend the cost and quality curve and transform the system.   

Regardless of the continued uncertainty in Washington, D.C. about how federal policy and the ACA will evolve, private employers, business coalitions and other purchasers are moving ahead with efforts to transform the system and derive more value from their health care spend.  I’m pleased to report that primary care is front and center to those efforts.

 
Kind Regards,

Ann Greiner 

 



  Ann Greiner, MCP
  President & CEO


 
PCPCC Comments to CMS to the Future of the Innovation Center

WASHINGTON –  The Patient-Centered Primary Care Collaborative (PCPCC) called on the Centers for Medicare and Medicaid Services (CMS) to maintain progress on its efforts to drive the shift to value, while empowering beneficiaries through the support of reliable access to primary care. 

“We are encouraged by the ideas outlined by CMS and urge the agency to use this opportunity to allay stakeholder concerns about the possibility of slowing government leadership in the transition to outcome-based payment,” said Ann Greiner, President and CEO of the Patient-Centered Primary Care Collaborative. 

Ms. Greiner said that the PCPCC supports CMS efforts to leverage payment models from other public and private programs and assign credit to clinicians and other providers participating in value-based models wherever due.  PCPCC also encourages CMS to actively work towards an environment in which the administrative burden on clinicians and other providers is both manageable and consistent across all payers. 

PCPCC encouraged CMS to continue its focus on the long-range vision of what our healthcare system should be and what individual steps are needed to achieve that vision, to ensure continuity, stability and ultimately health system transformation.

PCPCC also encouraged an emphasis on ensuring every American has access to primary care physicians and other clinicians in their community, that healthcare providers engage in coordinated team-based care and preventative and population-based health, that patients are engaged and active participants in their health and well-being and that payment emphasize value – not volume in healthcare delivery.

Read the full comments

Webinar In January: Oregon's Innovative Patient-Centered Primary Care Home Program

Evan Saulino, a family physician at the Providence Southeast Family Medicine Clinic, will describe innovative work by the Oregon Health Authority Patient-Centered Primary Care Home Program (PCPCH). Dr. Saulino acts as the Clinical Advisor for Oregon’s PCPCH Program, which works with clinics serving over 3 million patients across Oregon. 

The Oregon Legislature established the PCPCH program in 2009 through passage of House Bill 2009. The goals of the program are to develop strategies to identify and measure what a primary care home does, promote their development and encourage Oregonians to seek care through recognized Patient-Centered Primary Care Homes.  


Dr. Salino will also describe the new OR legislation, passed in July 2017, to double over a five year period the amount of money spent by all OR payers on primary care.  These additional funds will be channeled into primary care alternative payment models.    

Save-the-date
January 30
3:00 - 4:00 PM ET
Please stay tuned for a registration link. 

 


2018 New Members and Executive Membership Recruiting/Renewal 
 
We would like to enthusiastically welcome seven new Executive Members already signed up for 2018. They include Humana, the National Coalition on Health Care, the National Pace Association, Oracle Corporation, The Verden Group's Patient Centered Solutions, the University of Michigan Department of Family Medicine and 4sight Health.  Welcome to the collaborative!

Thank you also for your continued support of the PCPCC.  Our Membership Team sent annual renewal notices to our Executive Members in October - and we are delighted by number of you who have responded so quickly!  

For those of you, who would like to become Executive Members, please don’t hesitate to email Krista Conley, COO, at [email protected].   


And, if you are kind enough to make a referral that leads to a new PCPCC Executive Member joining in 2018, we will be pleased to reward you with a $100 gift certificate or donation to a charity of your choosing.  
 
In our December newsletter, we will release PCPCC's 2018 Calendar of Events, an exciting mix of policy and membership events, designed to support our collective efforts to advance primary care, as well as to support member engagement. 
Upcoming Events
 
Navigating Complex Change with Myers-Briggs Type Indicator (MBTI)
December 5, 2017

PCPCC Webinar - Oregon's Innovative Patient-Centered Primary Care Home Program
January 30 , 3:00 - 4:00 PM ET
(registration link coming soon)

Contact Allison Gross, [email protected] for promotional opportunities. For additional events, click here.
News of Note
 
11/22 | PCPCC
 
11/15 | Joanne Finnegan, Fierce Healthcare
 
11/11 | Daniel Wolfson
 
11/11 | Glen Stream
 
11/09 | Salvador Rodriguez
 
11/08 | Kansas City Business Journal
 
11/04 | Richard Thaler
Copyright © 2017 Patient-Centered Primary Care Collaborative

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