PCC Fall 2020 Newsletter

 
 

In This Issue

Click on a link below to be taken to that article.

Message from the President & CEO
Focusing on Need for More Primary Care Research
Policy & Advocacy Update
Why You Should Join the PCC
Executive Member Spotlight: National PACE Association
Register Now for PCC's Virtual Annual Conference
Sponsor the PCC’s Virtual Annual Conference
PCC Webinars
New Initiative Aims to Showcase What Makes Healthcare Organizations Trustworthiness
New Articles, Research & Resources
Upcoming Conferences, Webinars & Events
Follow PCC on Facebook and Twitter
 
 

Message from
Ann Greiner,
President & CEO






Dear Colleagues,

The pandemic is catalyzing significant change in primary care, with the uptick in telehealth visits a critical strategy to providing care while keeping patients and clinicians safe. This context prompted the formation of the Taskforce on Telehealth Policy (TTP), which on Sept. 15 issued an important report. The taskforce’s findings and recommendations will be in the mix as policymakers chart the road ahead for telehealth now and post-pandemic.
 
The PCC is preparing a formal and official statement in response to the TTP’s report, which we will release soon, but in the meantime, I want to provide some of my own initial reactions. In light of the TTP’s final report, I believe policymakers need to consider the following
  • Focus on embedding telehealth within the existing patient-centered medical home, rather than developing a stand-alone virtual medical home model
  • Continue to provide telehealth parity – potentially until the COVID-19 vaccine is widely distributed
  • Support global, prospective payment for primary care that allows for flexible integration of telehealth when and where appropriate. This allows practices to be agnostic as to what platform they use to deliver care.
  • Address the underlying factors that exacerbate health inequities, including those that may be connected to telehealth
PCC’s statement will be out shortly, but these are initial thoughts about this important report.
 
Register now for the PCC 2020 Virtual Annual Conference
 
I’m excited to invite you to attend our annual conference, which will happen virtually this year on November 30 and December 1. Registration is open now, and I encourage you to secure your spot under early-bird rates. Telehealth will be on the program, along with presentations and discussions on how the pandemic, the economic downturn, the renewed conversations about racial and health inequities, and a new Congress is catalyzing changes in primary care. The conference is our chance to come together as leaders in the primary care community and to put ourselves on the forefront of reimaging primary care and shaping its future. I hope to see you online at the conference!
 
Kind regards,

 

Capitol Hill Briefing Focuses on Need for More Primary Care Research

An independent study mandated by Congress in 2018 and commissioned by the Agency for Healthcare Research and Quality (AHRQ) has concluded that federal investments in health services research and primary care research are integral to the nation’s healthcare system. The study looked at federally funded research conducted in those areas between 2012 and 2018 with the purpose of increasing the impact of research by identifying research gaps and proposing strategies for better coordination across the federal government. AHRQ contracted with the RAND Corporation to conduct this independent analysis.
 
Read the summary and full report.
 
On Sept. 25, the PCC, along with the Council of Academic Family Medicine, the Society of General Internal Medicine and the American Board of Family Medicine, sponsored an online briefing for congressional staff on the study (watch the video recording | get the slides). The PCC's President and CEO, Ann Greiner, spoke at the briefing.  Key messages from the briefing included:
  • Primary care research’s distinction from health services research
  • Identification of gaps in primary care research
  • Primary care research has been consistently underfunded over the years.
  • The need to invest $5 million right now in AHRQ’s Center for Primary Care Research to provide a targeted funding line to begin addressing these concerns 
Gopal Khanna, MBA, director of AHRQ, said, “The COVID-19 pandemic has shown us that we need answers, now more than ever, to the complex challenges that can undercut our healthcare system’s effectiveness.” Khanna was commenting on the AHRQ study’s results, which were released in late June.
 
The report’s other findings related to primary care research:
  • Primary care research is critical and underfunded but has had a significant impact on patients’ lives and the quality, safety, and value of the healthcare services they receive.
  • These impacts are often cumulative across agencies’ portfolios.
  • With distinct missions and focus areas, HHS agencies play unique roles in primary care research funding.
  • As with health services research more generally, there are opportunities for novel forms of primary care research that will improve its impact.
 

Policy & Advocacy Update

Stopgap funding bill set to pass


Congress is set to pass a stopgap funding bill that will keep the government funded through mid-December. The House has already passed H.R. 8337 (116), and the Senate is expected to pass it today, with the president signing before midnight. The continuing resolution (CR) extends current funding levels through Dec. 11 and does not include additional funds for healthcare providers after Speaker Nancy Pelosi and Treasury Secretary Steve Mnuchin agreed to a "clean" CR. Talks around another coronavirus response package continue, but their likelihood to pass before the election remains uncertain.

 
Pediatric care down sharply due to pandemic


Last week, the Centers for Medicare and Medicaid Services released Medicaid and CHIP data showing a “drastic decline” in vaccinations and other routine and preventative care for children. Compared to the same period last year, 2020 data shows 22% fewer vaccinations for children up to age two; 44% fewer child screening services; and 69% fewer dental services. These declines were seen despite increased use of telehealth, leading the agency to issue an “urgent call to action” to ensure accessible services for all children and avoid long-term health consequences. (Watch the recording of the PCC’s most recent monthly webinar, which addressed this topic, among others.)

 
CMS loan recoupment delayed


In August, CMS was scheduled to begin recouping loans made to healthcare providers through its Accelerated and Advance Payment (AAP) Programs; however, Administrator Seema Verma had paused the loan payback while waiting on potential congressional action. That action came this week through the continuing resolution that delays the recoupment start date from the original timeframe (120 days after the loan was made) to one year after the loan was made. The bill also includes an extended repayment timeline and a reduced interest rate of 4%, down from 9.6%. Separately, CMS has clarified that financial support through the Provider Relief Fund and forgiven small-business loans such as PPP will not count against providers in future Medicare payment calculations.
 

The latest on telehealth


In early August, President Trump signed an executive order that directs CMS to make permanent some of the 135 telehealth services that had temporarily been added during the public health emergency. At the same time, healthcare payers and other stakeholders continue to assess the impact of telehealth on safety, quality, and costs. This includes the Taskforce on Telehealth Policy, convened in June by NCQA, Alliance for Connected Care, and the American Telemedicine Association. The taskforce’s report, issued Sept. 15, offers recommendations for future telehealth policy based on telehealth utilization during the pandemic and input from hundreds of stakeholders through townhall convenings and written comments. Academics and think tanks also continue to explore how to best integrate and pay for telehealth, including in this Commonwealth Issue Brief: “Telemedicine: What Should the Post-Pandemic Regulatory and Payment Landscape Look Like?” and in this Health Affairs Blog post: “Five Ways—Beyond Current Policy—To Truly Integrate Telehealth Into Primary Care Practices.” And AHRQ announced that next month it plans to release a new patient experience survey to assess satisfaction with telehealth visits. (Register for the PCC’s next monthly webinar—Making the Call on the Best Use of Telehealth in Primary Care—on Oct. 21 from 4:00 to 05:00 p.m. EDT.)

 
Proposed 2021 Medicare Physician Fee Schedule


Last month, CMS released its calendar year 2021 Medicare Physician Fee Schedule (MPFS) for comment. The proposed rule includes a budget-neutrality adjustment to offset, in part, the increased rates for office/outpatient Evaluation and Management services set to take effect this January. The proposed adjustment reduces the Medicare conversion factor by about 10% from $36.09 in 2020 to $32.26. Primary care clinicians will see increases between 8% and 13%. Other MPFS changes include adjustments to reporting and measures for the Medicare Shared Savings Program and MIPS. The PCC is working with its Policy Committee to submit a comment letter on the proposed rule by CMS’s Oct. 5 deadline.
 

New report on capturing non-fee-for-service spending to measure investment in primary care


Rand Corp. has issued a new report, funded by the Milbank Memorial Fund, that explores how to capture non-fee-for-service spending when measuring levels of primary care investment. Health care is moving away from traditional claims with greater adoption of alternative payment models, although the pace is slow. The report identifies key policy decisions that must be answered in order to capture these non-FFS investments—such as risk sharing, provider incentives, HIT, and workforce expenditures—to more accurately measure and compare levels of primary care spending. This topic will be explored further at the PCC Executive Member and State Policymaker Workshop on Dec. 2.
 

Welcome to a New Executive Member!



We would like to welcome our newest Executive Member, Ascension Medical Group, which joined the PCC in September. We are happy to announce this addition and look forward to working with and learning from Ascension moving forward.


Interested in becoming an Executive Member of the PCC?
 

Membership in the PCC Has Its Privileges

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 three workgroups
  • Receive discounts on event registrations 
  • 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 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: 
 
Jennifer Renton
Membership Coordinator
membership@thePCC.org
 
Get more information and apply for membership
 

Executive Member Spotlight: National PACE Association

This is a regular feature of PCC’s monthly enewsletter. We focus on a different Executive Member of PCC every month and spotlight some of the current campaigns, initiatives or work in primary care that they’re implementing.

 


The National PACE Association (NPA) has been an Executive Member of the PCC since January 2018. Its mission is to provide leadership and support for the growth, innovation, quality and success of the Program of All-Inclusive Care for the Elderly (PACE®) Model of Care. This model is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. September is National PACE Month.
 
As an association, NPA is a membership-based organization, and its main membership consists mostly of healthcare services providers that work under the comprehensive PACE approach. Some of the areas the association works in:
  • Advocacy and federal policy: Part of this area includes working in coalition with other organizations in Washington, D.C., to advocate for strengthening the ability of the healthcare system to provide appropriate care and to support the efforts of families and friends to assist older Americans.
  • Data: NPA collects data from participating PACE sites to help them compare the provision of services and participant characteristics across PACE sites. This benchmarking data helps PACE staff to continuously improve service delivery.
  • Research: NPA supports the study of innovative and integrated models of care with the goal of improving the lives of frail older persons and others, regardless of the healthcare setting. 
How Primary Care Fits in to the PACE Model
 
A PACE program provides the entire continuum of care and services to seniors with chronic care needs by delivering all needed medical and supportive services. These services include, among others, adult day care that offers nursing; medical care provided by a PACE physician familiar with the history, needs and preferences of each participant; home health care and personal care; and all necessary prescription drugs. All of these listed services have a connection in some way to primary care clinicians or practices.
 
The care provided by PACE programs is often described as community-based, comprehensive and accountable, with the goal of providing quality care, improved health and value for the healthcare system. There is considerable overlap of these PACE characteristics with the Shared Principles of Primary Care, a vision of primary care that over 350 organizations have signed on to support. 
 
A 2010 research report (Boult, C., Wieland, G.D. (2010). Comprehensive primary care for older patients with multiple chronic conditions: "Nobody rushes you through.” JAMA, 304 (17): 1937-43) identified PACE as one of three chronic care models that include processes that improve the effectiveness and efficiency of complex primary care. PACE also emphasizes timely preventive primary care over specialty and institutional care.
 
 

Register for the Primary Care Collaborative's Virtual Annual Conference, Nov. 30-Dec. 1



 
REGISTER NOW
The Primary Care Collaborative's (PCC) 2020 Virtual Annual Conference will bring together top leaders from all major stakeholder groups who are passionate about making primary care better and more equitable – an endeavor even more pressing given the challenges our country is currently facing. Join hundreds of other primary care leaders online from wherever you are for this highly interactive virtual conference! It's an opportunity to hear from well-known national experts and thought leaders on a range of topics within primary care. There will also be many opportunities to connect with other attendees in virtual networking sessions.
 


This year’s momentous events – the pandemic, the economic downturn, the renewed conversations about racial and health inequities, and the November election – all have the potential to impact and be catalysts for changes in primary care. That’s what makes this year’s conference even more significant. It is our chance to come together as leaders, experts and other professionals in the primary care community and to put ourselves on the leading edge of reimaging primary care and shaping its future.

We're assembling an impressive lineup of speakers and sessions, including:

  • Joseph Betancourt, MD, MPH, Vice President, Chief Equity and Inclusion Officer of the Office of Equity and Inclusion at Massachusetts General Hospital, who will deliver the opening keynote about the vulnerabilities in primary care and deep inequities in society and health care that COVID-19 has laid bare and how can primary care respond
  • A diverse panel of patients who will address patient needs and preferences during and beyond the pandemic, including those related to telehealth, access and convenience, depth of clinician-patient relationships, and more, moderated by Sinsi Hernández-Cancio, JD, Vice President for Health Justice at the National Partnership for Women and Families
  • A panel discussion, featuring Ian Tong, MD, Chief Medical Officer, Doctor on Demand, on how the physical locations of primary care and telehealth work together to meet patient needs, address equity gaps and enhance value
REGISTER NOW
 

Sponsor the PCC’s Virtual Annual Conference

The PCC is grateful for your engagement with us, including by receiving and reading this quarterly newsletter or attending one of our monthly webinars. We hope our communications and programming have helped to keep you abreast of the latest issues in primary care.
 
To continue these free services for the broad primary care community, please consider if your organization is in a position to further support the PCC through sponsorship of our upcoming annual conference. This event – Crisis as Catalyst: Reimagining Primary Care – will happen virtually on November 30 and December 1 and is not just for members of the PCC. Invitations to attend will be going out shortly. 
 
Sponsorship gives your organization convenient and concentrated access to these leaders in the midst of the conference’s objectives to educate, inspire and unite the primary care community. The tools we will be using to conduct a web-based conference will give you many creative ways as a sponsor to engage with attendees.
 
The sponsor prospectus provides more information about the conference, the value of sponsorship, and the many related opportunities. To express your interest, or if you have questions, please fill out the form on that page or contact:
 
Jennifer Renton, PCC Membership Coordinator
jrenton@thepcc.org
913-669-1181
 
As a sponsor of the 2020 PCC Virtual Annual Conference, your organization will be recognized as a thought leader and supporter of advanced primary care, including the Patient-Centered Medical Home (PCMH). You will be seen as a primary care champion at a critical time in our nation’s history and the evolution of our health system.
 
 

PCC Webinars

Upcoming Webinar

Wednesday, October 21, 2020
4:00 to 5:00 p.m. EDT

At the beginning of the pandemic, telehealth use skyrocketed because clinicians and patients needed to be safe while providing and receiving needed care. Now, with many months of experience in heavy telehealth use, it’s worth taking stock of its profusion into primary care and evaluating which policies and practices make sense to continue in order to achieve the best health outcomes, advance efficiencies in care, and meet patient needs and preferences. This webinar will examine ways primary care can prepare for a post-pandemic future and integrate telehealth into primary care practices in the right way. We’ll look at how telehealth can become a regular tool of primary care without fracturing it or weakening the clinician-patient relationship.

Register for this webinar

Most Recent PCC Webinars

 

Primary Care's Got Your Back to School

September 21
For many, this year’s back-to-school season during a protracted pandemic is fraught with health risks and questions about student and teacher safety. Parents and teachers are concerned about the spread of the coronavirus in schools and between schools and homes. Primary care can help families navigate these uncharted waters. This webinar examined the role of primary care for children in the risk assessment, prevention, and treatment of COVID-19 as well as in addressing related behavioral health needs and inequities in care. The webinar also addressed planned vaccinations.

Panelists:

  • Chip Hart | Consulting group director, PCC Pediatric EHR Solutions
  • Nathaniel Beers, MD, MPA, FAAP | President, HSC Health Care System (Washington, D.C.)
  • Ashraf Affan, MD | President, Angel Kids Pediatrics (Jacksonville, Florida)

Moderator: Sarah Greenough, MPP | Director of Policy, Primary Care Collaborative


What Do Patients Want From Primary Care – Both During and After COVID-19?

August 19
A key part of PCC’s mission is working to make primary care more responsive to patients’ needs and preferences. This webinar featured two major efforts to systematically gather the perspectives of patients in primary care: Community Catalyst’s November 2019 report, “In Their Words: Consumers’ Vision for a Person-Centered Primary Care System,” based on nine focus groups in four states; and regular surveys of patients and clinicians by the Larry A. Green Center and PCC during the COVID-19 pandemic. The webinar considered what patients are looking for overall, with a lens on those who are most vulnerable, including patients facing racial and economic disparities. Through brief presentations of the data and a moderated discussion, panelists considered what primary care is doing well and where practice and policy changes are needed. They also highlighted how the pandemic is shaping interactions between primary care clinicians and patients and what may be on the horizon.

Speakers:
  • Ann Hwang, MD | Director, Center for Consumer Engagement in Health Innovation at Community Catalyst
  • Rebecca Etz, PhD | Co-Director, Larry A. Green Center
  • Lynda Flowers, JD, MSN, RN | Senior Policy Advisor, AARP Public Policy Institute
Moderator: Ann Greiner | President and CEO, Primary Care Collaborative
Watch past webinars
 

New Initiative Aims to Showcase What Makes Healthcare Organizations Trustworthiness; Seeking Submissions



The Building Trust initiative of the ABIM Foundation will showcase practices and actions that healthcare organizations can take to enhance their trustworthiness. The ABIM Foundation is actively recruiting partners that can share successes and lessons learned from their own attempts to enhance trust. Participants in Building Trust will join a vanguard community of organizations from across the healthcare system and will have the opportunity to publicize their own trust-building practices.
 
Although it is not required, participants are encouraged to share actions and practices that they have put in place to respond to COVID-19 and/or systemic inequities that affect health.

For more information, please contact Daniel Wolfson, the Executive Vice President and COO of the Foundation, at dwolfson@abim.org. You can also visit the initiative’s website for more information and to find a submission form that you can use to describe your practices and actions that promote trust.
 
 

New Articles, Research & Resources

Prospective Payment for Primary Care: Lessons for Future Models

 
The COVID-19 crisis and resulting financial pressures on vital primary care services have demonstrated the hazards of the fee-for-service payment system. Prospective payments for primary care are an alternative mechanism that offers flexibility and greater revenue certainty. This new Milbank report analyzes earlier primary care prospective payment models, such as those commonly employed in the 1990s, and offers insights for designing prospective payment for primary care and review payment design considerations.
 

Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic


In this survey study that included 1,441 respondents from during the COVID-19 pandemic and 5,065 respondents from before the pandemic, depression symptom prevalence was more than three-fold higher during the COVID-19 pandemic than before. Lower income, having less than $5,000 in savings, and having exposure to more stressors were associated with greater risk of depression symptoms during COVID-19.
 

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.

 

Redesigning Primary Care for Quality, Safety and Equity in the Time of COVID

Thursdays from 1 to 2 p.m. EDT, starting September 3, 2020
A virtual 10-week improvement program by the Center for Primary Care at Harvard Medical School to support primary care practice leaders and teams to provide high-quality virtual and in-person patient care safely and equitably while building resilience strategies for the future.
 

Virtual Twentieth Anniversary Population Health Colloquium

October 5-7, 2020
Produced by Global Health Care, LLC
Features leaders who are transforming health care in the wake of COVID-19. With a new focus on the pandemic's impact on healthcare, the Colloquium will showcase the groundbreaking work of organizations that are leading the way during this unprecedented time and putting their population health programs, strategies and initiatives into action.

 

2020 LAN Virtual Summit

October 13, 2020
This Health Care Payment Learning & Action Network event will center around how value-based payment models and the larger healthcare system have adapted to become more responsive and resilient in the wake of the public health emergency. Sessions will also focus on health inequities/disparities in outcomes; integration of specialties, like behavioral health, with primary care; capacity building for health systems and independent physician practices

 

Addressing Traumatic Brain Injury and Mental Health in Primary Care

October 27, 2020
1:00-2:30 p.m. ET
This free, 90-minute training is the final session of the Mountain Plains Mental Health Technology Transfer Center's six-part series on the intersection of traumatic brain injury and mental health. It will focus on the primary healthcare community. Drawing on principles presented in previous webinars, this session will address specific concerns of the primary healthcare community concluding with an overview of the series and a Q & A session.
 

PCC's 2020 Annual Conference:
Crisis as Catalyst: Reimagining Primary Care

November 30-December 1, 2020 | online
See the full announcement for this event.
 

Primary Care Investment 2.0—State Innovation Workshop (for PCC Executive Members and invited guests)

December 2, 2020 | online

PCC Executive Members and invited guests are welcome to join us for this half-day session, which will bring together PCC Executive Members along with state leaders, policymakers, and advocates to explore the next wave of state-level efforts to measure and set targets for levels of primary care investment.

Through panels, virtual peer networking and small group discussions, the workshop will highlight best practices and provide space for attendees to connect across regions and stakeholder types and discuss shared agendas for advancing investment in primary care in 2021 and beyond.


Medical Director Leadership Institute

Six-month virtual offering: January 14, 2021 to June 12, 2021
First Thursday of each month, 10:00 a.m.-1:00 p.m.
 
 

Follow PCC on Facebook and Twitter

Are you active on social media?

Follow PCC on Facebook and Twitter. PCC provides regular announcements and updates on:
  • upcoming PCC webinars
  • PCC’s upcoming virtual annual conference (Nov. 30-Dec. 1)
  • events of interest to the primary care community, such as Twitter chats
  • policy and advocacy issues
  • news and developments in primary care
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