PCC 2020 Spring Newsletter

 

March 2020

 
 

COVID-19 and Primary care

Weekly Survey of Primary Care Practices on Response to COVID-19  

 
The coronavirus is having a major impact on patients and the U.S. health care system – including primary care. To track the impact of the coronavirus and what is needed to respond, the Primary Care Collaborative is partnering with the Larry A. Green Center, which is conducting a weekly survey of primary care clinicians on their responses to the COVID-19 crisis. 
  
The goal of this effort is to regularly assess primary care’s ability to evaluate and manage patients in the midst of COVID-19. Information gathered in the survey during this crisis will be used to inform the policy proposals of PCC, its Executive Members and the broader community. 
 
PCC is sharing the survey’s results each week on its website. See the most recent results. 
 

Take the Survey and Invite Others in Your Networks to Do So

  
If you are a physician, nurse practitioner or PA working in primary care, you are invited to take the survey. Completing the survey takes 3 minutes or less. 
  
Executive Members of PCC and other associated organizations are invited to ask their own members – those who are physicians, nurse practitioners or PAs – to take the survey. Consider sending out your own message about the survey in your newsletter, on social media, or in other member communications. Suggested text
 

What Else Are You Doing to Respond to COVID-19? 

  
We would like to hear from you about innovations you have put in place to address needs that have arisen as a result of COVID-19. How have you improvised in your practice as this health emergency has developed? What new and different ways are you responding to patients' needs? What new systems or practices have you put in place?   
  
The broader community is looking to crowd source good ideas. Drop us a line at Comun[email protected]. Thank you!
 

Welcome to New Executive Members!

The PCC would like to welcome our newest Executive Members:
We are happy to announce these additions and look forward to working with and learning from these members moving forward. 
 

Policy & Advocacy Update

Relaxed Telehealth Restrictions from CMS


On March 17, CMS issued new guidance on telehealth services for Medicare beneficiaries to help providers more flexibly diagnose and manage patients during the novel coronavirus pandemic. Telehealth visits under Medicare are now reimbursed at the same rate as in-person visits, and practices have the flexibility to reduce or waive cost sharing for patients. This applies to physicians, nurse practitioners, clinical psychologists, and LCSWs. The updated policy also temporarily waives geographic and originating site restrictions for telehealth that previously limited eligibility to patients in rural areas who travel to a medical facility to access the services. During the emergency period, providers may now use a range of virtual platforms—including Skype, Facetime, and Google Hangouts—as long as they are “good faith use of telehealth.” The eased restrictions were based on authority granted in the “Phase 1” stimulus package as well as the president’s national emergency declaration.
 

Growing Number of Emergency Medicaid Waivers


The president’s national emergency declaration on March 13 authorized states to apply for 1135 waivers granting time-limited flexibilities to respond to the crisis. As of Friday, 34 states had been granted Medicaid waivers that offer a range of flexibilities such as the abilities to enroll out-of-state or new providers more quickly and to temporarily suspend prior authorization requirements. See the latest list of state waivers on Medicaid’s website.
 

Stimulus Packages Passed to Respond to COVID-19


Congress has passed three stimulus packages to respond to the clinical and economic toll of the pandemic. The first package (“Phase 1”), passed March 4, provided billions of dollars to federal agencies to combat the virus’s spread and additional funds to ramp up testing. Phase 2 passed ten days later; it covered emergency provisions spanning food aid, paid sick leave, free COVID-19 testing for the uninsured, and unemployment insurance. Cost-sharing for visits relating to testing was waived for Medicare Part B, Medicare Advantage, Tricare, Medicaid/CHIP, Veterans, and Indian Health Service. The bill also included a temporary 6.2 percentage point increase to states’ federal medical assistance percentage (the federal portion paid to Medicaid) for coverage of testing for the duration of the public health emergency. Phase 3—a $2 trillion package—passed the house on Friday. PCC is advocating that the direct relief allocated to states, ranging from $1.25 to $10 billion, be used, in part, to help sustain and strengthen primary care practices as they continue to serve as front-line responders.
 

MIPS Short-Term Reporting Relief


CMS has adjusted reporting requirements for the Quality Payment Program (QPP) in light of the COVID-19 situation. The 2019 Merit-based Incentive Payment System (MIPS) data submission has been extended from March 31 to April 30, 2020. Participating clinicians who do not submit data by April 30 will qualify for the “automatic extreme and uncontrollable circumstances policy” and receive a neutral payment adjustment for the 2021 payment year. CMS implemented the policy to provide relief to clinicians who are actively responding to COVID-19. PCC commends CMS on the policy and is urging the waiver to be extended into 2020.
 

PCC Comment Letter: Protect CMMI’S Ability to Advance Value-Based Models


In March, PCC issued two comment letters to Congress. The first expresses opposition to H.R. 5741 and calls to protect CMMI’s ability to advance value-based payment models for beneficiaries. While the “Strengthening Innovation in Medicare & Medicaid Act” was framed as a way to increase accountability for the Center for Medicare & Medicaid Innovation (CMMI), PCC is concerned that the legislation will impede the Innovation Center’s ability to agilely test and scale payment models. The letter asserts that the bill weakens CMMI's autonomy, introduces opportunities to politicize payment models, and adds unnecessary administrative burden.
 

PCC Comment Letter: Protect Final Physician Fee Schedule


A second PCC comment letter called on Congress to protect the final 2020 Medicare Physician Fee Schedule (PFS), which includes much-needed re-valuations for primary care. PCC believes the policy changes issued by CMS are well-justified by evidence, reflect current practice patterns, and are fiscally prudent. The final fee schedule includes higher values for E/M office visits and a visit complexity add-on payment starting in 2021; both help to re-align an unbalanced health care system that today better compensates “downstream” acute and specialty care over “upstream” prevention and chronic disease management.


Connecticut Executive Order: 10% PC Spending Target


Connecticut is the latest state to set a target for primary care investment. At the end of January, Governor Ned Lamont (D) issued Executive Order No. 5, directing the Office of Health Strategy to establish statewide healthcare cost growth and quality benchmarks and to reach a primary care spending target of 10% by calendar year 2025.
 

State Primary Care Investment Efforts Continue


Over the last quarter, five states (Washington, Colorado, Vermont, Maine and Oregon) issued their annual primary care investment reports. Read all the reports on our PC Investment web page, and check out the latest state legislative updates summarized on our new state factsheet.
 

PCORI Update

 
PCC's PCORI-funded Eugene Washington PCORI Engagement Award project came to a close at the end of February, but the work continues to support PCC's dissemination and communication efforts. Most recently, PCC has been working with our database of subscribers to identify our most engaged audience. These supporters can be targeted with future messages and surveys to help us improve even further. Using survey data from our webinars, PCC has been able to identify future topics for education and exploration as well as opportunities to engage with new partners. Through the course of this project, PCC has learned how to better engage with different audiences to spread research results and advance best practices and policies for primary care.

PCC would like to thank all of the individuals and organizations that contributed to this work by serving on the project's Advisory Council:
  • American Academy of Pediatrics, Debra Waldron
  • American College of Physicians, Shari Erickson
  • American Association of Nurse Practitioners, Dianne Padden 
  • American Psychological Association, Elena Eisman and Stephen Gillaspy
  • American Osteopathic Association, Kenya McRae
  • BCBS Michigan, Amy McKenzie
  • Black Women's Health Imperative, Linda Goler-Blount
  • CVS Health, Beth Kinsella
  • Families USA, Ellen Albritton and Denisse Sanchez
  • Johns Hopkins Medical Institute, Steven Kravet
  • Informed Patient Institute, Carol Cronin
If you are interested in learning more about this work or following PCC's future research updates, sign up for our research newsletter, "Focus on Research: Curated Findings Related to Advancing Primary Care."
 
Sign up for the newsletter
 

PCC Webinars

Most Recent PCC Webinars


Recognizing & Incentivizing Behavioral Health Integration: What's Next for Accreditors and Employers?
March 2
Attendees had an inside look at new, innovative models that employers and accreditors are using to incentivize behavioral health integration in practice.

Speakers included:
  • Michael Barr, Executive Vice President, National Committee for Quality Assurance
  • Michael Thompson, President & CEO, National Alliance of Healthcare Purchaser Coalitions
  • Shawn Griffin, President & CEO, URAC 
  • Julie Schilz, Senior Director, Mathematica

Strengthening Trust and Equity in Primary Care
January 29
This webinar focused on the concepts of trust and equity and how the two are closely linked in health care. Speakers discussed the importance of building trust in working to address and eliminate health disparities.
 
Speakers included:
  • Daniel Wolfson, Executive Vice President & COO, ABIM Foundation 
  • Evelyn Figueroa, Program Director, Family Medicine Residency, University of Illinois at Chicago College of Medicine
  • Dominic Mack, Professor, Family Medicine, Morehouse School of Medicine
  • Jennifer Edgoose, Associate Professor, University of Wisconsin School of Medicine and Public Health
Watch past webinars

Upcoming Webinar


Primary Care's Role in Responding to COVID-19
Learn more about the coronavirus outbreak, its impact on practices and patients, and how primary care is responding. This discussion with primary care leaders will address issues spanning primary care capacity, virtual visits, and community-based approaches to care in the midst of COVID-19.

Wednesday, April 15, 2020
2:00-3:00 p.m. ET

Panelists:
  • Darilyn Moyer, MD, FACP, FRCP, FIDSA, Executive Vice President & Chief Executive Officer, American College of Physicians
  • Ian Tong, MD, Chief Medical Officer, Doctor On Demand 
  • April Joy Damian, PhD, MSc, CHPM, PMP | Associate Director, Weitzman Institute
Moderator:
Beverly H. Johnson, President & CEO, Institute for Patient and Family-Centered Care 
 
Register for this webinar
 

Event Highlights

Primary Care Summit


On Tuesday, March 24, the Primary Care Development Corporation (PCDC) hosted a summit called "Rebalancing Health Care Spending" during which national experts discussed what the states are doing to tackle this problem, build health equity, and turn us towards a high-performing, primary care-focused system.
 

Stopping the Spread of Coronavirus: What Federal and State Governments Can Do to Increase Access to Treatment and Prevention


On Tuesday, March 17, the Commonwealth Fund hosted an educational briefing for journalists and policymakers where leading experts discussed the tools and resources that states and the federal government have at their disposal to address the pandemic, how we can expand access through Medicaid, and what the federal government has the capability to do with emergency powers in place. It was importantly noted that essential health benefits (EHB) do require insurance plans to cover COVID-19 testing, but these do not apply to large employers or self-insured plans, leaving out a large portion of the population. Experts also discussed the potential of using 1135 waivers to help quicken the provider response and reduce barriers to payment.
 

COVID-19 Update


On Tuesday, March 17, PCC's team as well as workgroup co-chairs received an update on the COVID-19 outbreak from Dr. Michael Fine. The discussion centered around the crisis for primary care providers in this time. Team members discussed important next steps for supporting the primary care community and enabling clinicians to confront the pandemic.
 

Social Determinants of Health and Health Policy


On Thursday, February 27, the Funders Forum on Accountable Health, in partnership with the GWU Milken Institute School of Public Health, hosted a panel event to explore how Accountable Communities for Health (ACHs) can help to address the social determinants, as well as policy implications, for ACHs. One panelist noted that ACHs could not be successful without the relationship with primary care. There is a bi-directional relationship between social needs and health outcomes that can only be addressed through expansive policy and process changes.
 

Incentivizing Recovery, Not Relapse: Paying for Outcomes in Addiction Recovery Services


On Wednesday, February 26, the Alliance for Addiction Payment Reform hosted an event regarding the Addiction Recovery Medical Home Alternative Payment Model (ARMH-APN), which was established to promote the type of integration and patient care capable of producing improved outcomes for patients, payers, and health systems long-term by aligning all incentives. Speakers, including PCC President & CEO Ann Greiner, discussed emerging value-based strategies aiming to address the challenges of delivering addiction recovery services in a fee-for-service environment. This alliance includes regular contributions by PCC board member Susan McDaniels; Dr. Laurie Sands, Distinguished Professor of Families & Health in the Department of Psychiatry and Vice Chair of the Department of Family Medicine at the University of Rochester and past president of the American Psychological Association, who provides a voice for primary care in this work.
 

Get the Medications Right: Innovations in Team-Based Care


On Thursday, February 6, the Bipartisan Policy Center and GTMRx Institute hosted a panel event based on new research that shows optimizing medication use—ensuring that the right medicine at the right dose is prescribed and used appropriately—can save a substantial number of lives and reduce healthcare costs in the United States. The event featured business, policy, and healthcare leaders who are at the forefront of delivery and payment models that support comprehensive medication management services. 


Health Care Innovators: Navigating the Healthcare Maze


On Wednesday, January 29, 2020, POLITICO hosted a deep-dive conversation sponsored by CVS Health on how to make navigating the healthcare system more effective and less costly. The intention was to help consumers make better healthcare decisions and take ownership of their care. Moderated by Joanne Kenen, panelists included Rep. Mark DeSaulnier (D-Calif.) of the Congressional Cancer Survivors Caucus; Gwen Darien of the National Patient Advocate Foundation; James Dias of Wellbe Inc.; and Bob McNellis of the Agency of Healthcare Research and Quality.
 

Public Session of the Committee on Implementing High-Quality Primary Care


On Wednesday, January 22, the National Academies of Sciences, Engineering, and Medicine’s Committee on Implementing High-Quality Primary Care hosted a public session to gather information on the state of primary care and paths forward for better care and outcomes. The committee will work to develop an implementation plan from the recommendations outlined in the 1996 IOM report, "Primary Care: America's Health in a New Era.”  Speakers at the public session—including federal agencies, specialty societies, and other report sponsors—advised the committee on priority focus areas to inform its work.
 

Save the Date for PCC’s Annual Conference

The coronavirus is all anyone can talk about these days, and primary care clinicians are playing an integral role in helping to minimize its impact on the broader community. While it shouldn’t take a crisis to bring attention to the importance of primary care, it may serve as an opportunity to further spread the message about the importance of a strong foundation of primary care as key to the nation’s health. 
 
We want you as a supporter of PCC to be the first to know that we’ve set the date for our annual conference, which is focused on improving investment in and innovative approaches to furthering comprehensive primary care, a topic made even more relevant due to current events. 
 
Investing in Comprehensive Care Now 
Washington Marriot at Metro Center 
Washington, D.C. 
November 5, 2020 
 
We’re committed to presenting a diverse lineup of influential speakers and perspectives that reflect the primary care community at large. If you have a speaker suggestion, please contact us at [email protected].
 

Invitation for PCC Members and State Leaders Only 

 
PCC Executive Members are invited to attend an exclusive workshop the day after the annual conference and awards dinner: 
 
Primary Care Investment 2.0—State Innovation 
November 6, 2020  

This half-day session will build on PCC’s first primary care investment workshop hosted in fall 2018. This year’s convening will bring together PCC Executive Members along with state leaders, policymakers and advocates to highlight lessons learned, engage with each other, tackle emerging issues, and discuss shared agendas for advancing investment in primary care. PCC will also release its 2020 Evidence Report at this event, which you will not want to miss.
 

Not a PCC Executive Member? Here’s Why You Should be One

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
  • receive the monthly member-only e-newsletter that highlights policy developments, upcoming events, and key issues related to primary care 
  • receive discounts on event registrations 
  • contribute to PCC’s policy and advocacy work 
  • sponsor events and initiatives   
  • do much more 
Visit the Executive Member page for more information, and watch the short (less than 2 minutes) video below that features current members and what they get out of their membership.
 
 
If you have questions about the membership process or benefits or would like to schedule a conversation, please contact: 
 
Jennifer Renton
Membership Coordinator
[email protected]
 
Get more information and apply for membership
 

Seeking Nominations for Consumer/Patient Position on PCC Board

PCC is seeking nominations for an additional consumer/patient position on its board of directors.  
 
Most recently, this position was occupied by Linda Goler Blount, President and CEO of the Black Women's Health Imperative. Beverley Johnson, President and CEO of the Institute for Patient- and Family-Centered Care, is currently serving on the PCC board as a consumer/patient representative.  
 
If you know a consumer/patient leader who is passionate about primary care, please submit his/her name and contact information to Evelyn Snyder at PCC ([email protected]).
 

Upcoming Events & Conferences

Duchenne Muscular Dystrophy Education Series 
Available now | American Association of Pediatrics | Webinar/Virtual

Second Public Session of the Committee on Implementing High-Quality Primary Care
April 1, 2020 | The National Academies of Science, Engineering and Medicine

Interoperability and Patient Access Final Rule Call
April 7, 2020 | Center for Medicare and Medicaid ServicesAnnConf

Primary Care's Role in Responding to COVID-19
April 15, 2020 | Primary Care Collaborative

Investing in Comprehensive Care Now
(see longer announcement about conference above)
November 5, 2020 | Primary Care Collaborative | Washington, DC
Primary Care Investment 2.0—State Innovation workshop (PCC Executive Members only)
November 6, 2020 
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