PCC Summer 2021 Newsletter

In This Issue
Click on a link below to be taken to that article.
 

Message from
Ann Greiner,
President & CEO





Dear Colleagues,

The Biden-Harris administration set a goal of getting 70% of Americans vaccinated against COVID by July 4. Although the U.S. is not expected to meet that goal, the urgency remains to double down on educating and reaching unvaccinated Americans.
 
As the administration itself has acknowledged (see Primary Points below), primary care is the trusted source for patients to get information on COVID and vaccines. Although it was brought in late to the country’s vaccination efforts, primary care is well poised to reach people who didn’t or couldn’t get vaccinated at large-scale or retail settings.
 
However, significant challenges remain. The COVID vaccine is currently being largely distributed through state health departments, unlike previous vaccines. One challenge in distributing and administering the vaccines through states is that there are variations in how connected public health systems are to primary care practices.
 
States such as Maryland, Vermont and others with high vaccination rates have good relationships and connections between public health departments and primary care. The administration is encouraging these connections and asking local and state public health departments to engage with primary care.
 
Integration of primary care and public health is essential not only for achieving herd immunity but also for future health emergencies. Integration is also vital to better address health inequities, made worse by COVID-19. As we emerge from the pandemic and re-imagine our health system, we need to invest more in primary care and public health and strengthen the primary care-public health relationship. Our health, our economy and our future depend on it.
 
Best wishes for a safe and healthy summer,
 

Biden-Harris Administration and Primary Care

  • On June 11, the White House held an online town hall titled “Primary Care Providers, Health Systems, and the Next Phase of the Vaccination Rollout.” Part of the Biden-Harris administration’s National Month of Action, it blanketed local TV, radio and social media to educate Americans about the COVID vaccines with messages from leading medical associations.
  • The town hall event included five conversations with prominent administration health leaders, including Drs. Anthony Fauci and Rochelle Walensky. Although it received mixed reactions during the broadcast, it was the most prominent public acknowledgement of primary care’s contribution to the COVID vaccination effort by the administration.
  • In opening remarks, Dr. Bechara Choucair, the White House’s Vaccinations Coordinator on the COVID Response Team, thanked the primary care community on behalf of the administration for its “tireless work over the course of this pandemic.” He acknowledged the critical role primary care clinicians have in administering the vaccine, particularly for people who still have questions about it. “You are the most trusted source of vaccine information for your patients and for your communities, and your offices are the most preferred location to get COVID vaccines,” he said.
  • Choucair hosted the final conversation on health departments’ role in ensuring that primary care practices have access to the vaccines. The chief medical officer in the Ohio Department of Health, representing the public health community, spoke of ways the department has been making it easier for primary care practices to administer the vaccines, such as allowing practices to order their vaccine supply directly, based on their own demand, rather than going through the health department. He encouraged state and local health departments to engage practices early in their effort, since practices know what the local challenges and opportunities for vaccinations.
  • Although primary care was brought in late to the massive national vaccine effort, this event showed that the administration is seeking practical ways of making vaccinates convenient and acceptable to every American and that primary care can be an integral part of it. Choucair concluded: “My call to action: If you’re not [administering vaccines], CDC offers resources and toolkits to support you to sign up, to become vaccinators … We have a sense of urgency. Pick up the phone. Talk to your patients. Send them text messages, emails, letters, for those who haven’t been vaccinated … Also make sure you’re very vocal about educating your patients and your community. Be engaged on social media and in regular local interviews.”
 

Coalescing Around the NASEM Report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care

 
The PCC is working with its members and other leaders in primary care to build unity and momentum for the bold changes the recent NASEM report calls for, particularly those related to payment reform. The report is an opportunity to shift the priorities of our healthcare system and improve the health of communities. The PCC is engaging our community in ongoing conversations to ensure our policy and advocacy agenda leverages this historic opportunity. (Watch the recording of PCC’s May webinar about the report.)
 

Affordable Care Act Celebrates a Good June

 
In early June, the Department of Health and Human Services announced that a record 31 million Americans were enrolled in coverage related to the Affordable Care Act as of February 2021, demonstrating its role as a lifeline for people facing economic and health hardships during the COVID-19 pandemic. Enhanced premium tax credits included in the American Rescue Plan enacted in March 2021 and available during an extended special enrollment period have reduced average monthly premiums by over 40% for returning consumers. Later in June, the U.S. Supreme Court upheld the ACA for the third time and dismissed a challenge brought by Texas and 17 other states on grounds that they were not harmed and therefore lacked standing. The challengers had argued that the entire law was invalid after Congress reduced to zero the ACA’s penalty for failing to enroll in minimum essential coverage in 2017.
 

Looking Ahead as Public Health Emergency Winds Down

 
As discussion continues about how to extend the enhanced subsidies in the American Rescue Plan, which will expire at the end of 2022, there are calls for improving affordability of both premiums and out-of-pocket costs in marketplace plans. Lowering out-of-pocket costs by making Gold-level plans affordable could improve access to primary care, particularly for lower-income enrollees.
 
Many temporary COVID-19-related Medicare payment and other waivers are tied to the duration of the national Public Health Emergency (PHE). The American Rescue Plan (ARP) included temporary funding and other temporary policy changes that have significant implications for the primary care community. The table below lists and tracks some important expiration dates.
 

FEDERAL PROGRAM/PROVISION

EXPIRATION DATE

Public Health Emergency (PHE) declaration from Secretary of Health and Human Services

Renewed 4/21/21 for 90 days; expected to be renewed through CY 2021

Provisions of $1.9 trillion American Rescue Plan

Medicaid state option for 12 months postpartum

5 years beginning April 2022

Enhanced FMAP (85%) for optional state community mobile crisis intervention services

5 years beginning April 2022

Two year 5% FMAP incentive (on all Medicaid populations) for states that have not yet expanded Medicaid (on top of 6.2% FMAP if during PHE)

2 years after state enactment

COVID-19 vaccine coverage for Medicaid/CHIP 100% match; state option for uninsured coverage

End of first quarter after 12 months after end of PHE

Temporary expansion of ACA marketplace APTCs

Expire at end of CY 2022

$8.5 billion for new fund for rural providers to cover losses due to COVID-19

Funds available until expended (providers must apply)

$9.1 billion for public health workforce-related grants; $100 million for Medical Reserve Corps; $800 million National Health Service Corps; $200 million Nurse Corps; $330 million for Teaching Health Centers GME (THCGME) programs

FY 2021; available until expended;

All programs extended through FY 2023

Community Health Center funding of $7.6 billion

End of FY 2022

$1.5 billion for Community Mental Health Block Grants; $1.5 billion for Prevention and Treatment of Substance Abuse Grants

FY 2021; expended by 9/30/25

Consolidated Appropriations Act, 2021

Medicare 2% sequestration suspended through 3/31/21; Congress extended again in April 2021

Expires end of CY 2021

Medicare PAY-GO cuts of 4% to be triggered by ARP deficit spending unless Congress acts

Congress must act by 9/30/21

One-time 3.75% ($3 billion) bump in Medicare physician fees to mitigate offsets in 2021 Physician Fee Schedule

CY 2021

Postponed complex E&M codes for Medicare billing

Until 1/1/2024
 

Other Federal Developments

 
Department of Health and Human Services
 
The Health Resources and Services Administration (HRSA) announced $125 million in workforce grants to support 14 nonprofit private and public organizations’ efforts toward underserved communities to “engage in locally tailored efforts to build vaccine confidence and bolster COVID-19 vaccinations.” These grants were authorized in the American Rescue Plan.
 
Centers for Medicare and Medicaid Services
 
CMS added 2019 Quality Payment Program performance information to the Doctors and Clinicians section of Medicare Care Compare and the Provider Data Catalog. More information.
 
Center for Medicare and Medicaid Innovation
 
Elizabeth Fowler, Deputy Administrator and Director of CMMI, has been engaged in a listening tour of stakeholders as part of a review of CMMI models and a new strategic focus. She has mentioned the importance of primary care in several public forums and has included the PCC in her stakeholder outreach. She has also spoken of the importance of incorporating health equity as a formal goal of alternative payment models.
 
MedPAC
 
In chapter two of its June report, MedPAC recommends that the Secretary of Health and Human Services “harmonize” and reduce its portfolio of alternative payment models and ensure they work together to support the strategic objectives of reducing spending and improving quality. This recommendation suggests that primary care stakeholders should evaluate the potential of all CMMI and CMS models to drive investment in and transformation of primary care.
 

Federal legislation

 
Telehealth
 
Bills related to telehealth continue to be introduced in both houses of Congress. The Alliance for Connected Care has a comprehensive list of bills and summaries.
 
Expansion of Teaching Health Centers
 
Noting that “we need more primary care physicians—that was true before this pandemic and its truer than ever now,” Senate HELP Committee Chair Patty Murray (D-Wash.) joined House Energy and Commerce Chair Frank Pallone (D-N.J.) in introducing new legislation to permanently authorize and expand the Teaching Health Centers Graduate Medical Education program. The bill, the Doctors of Community Act, would expand funding to support 100 new programs and 1,600 new residency slots, which would be filled primarily by residents in primary care.
 
E&C Hearing: Empowered by Data: Legislation to Advance Equity and Public Health
 
On June 24, the House Energy & Commerce Committee held a hearing on strategies for digitizing the nation’s public health data systems, insuring interoperability and collection of meaningful, actionable data to support addressing social determinants of health and health equity. Committee members have introduced a series of bills to address these goals. Funding an interoperable public health data system is foundational to successful models of comprehensive primary care.
 

State developments

 
States Codify Telehealth Payment Parity
 
As states are ending state-level public health emergencies that temporarily added new telehealth payment coverage in Medicaid and other state-funded or -regulated programs and payers, many states are codifying telehealth payment parity for telehealth on a permanent basis. Manatt has a helpful tracker.
 
California Medicaid RFP
 
The California Department of Health Care Services solicited public comments on its draft request for proposal (RFP) for upcoming procurement of Medi-Cal (Medicaid) managed care plans. This is the first time California has conducted a statewide procurement, and it will cover 11 million Medi-Cal enrollees. The California Health Care Foundation publicized the opportunity for stakeholders to weigh in on ideas to improve access, equity and quality of care. Re-bidding state Medicaid managed care contracts is an important opportunity for primary care advocates to promote effective contracting practices (including reporting primary care spending), oversight and accountability processes, and appropriate alignment with other state payers and purchasers to advance comprehensive primary care.
 

PCC Welcomes Two New Board Members
The PCC is pleased to have two new members on its board of directors: J. Nwando Olayiwola of Humana and Lisa M. Gables of the American Academy of PAs.

“We are thrilled to have Nwando and Lisa join the board of directors,” said Ann Greiner, PCC’s president and CEO. “Nwando brings a wealth of experience as both an innovator in primary care and as a health equity leader, both critical areas where the PCC is expanding its work. As the new CEO of AAPA, Lisa represents a critical part of the primary care team, and her experience in the aging community is invaluable.”


J. Nwando Olayiwola, MD, MPH, FAAFP


Chief Health Equity Officer and Senior Vice President, Humana, Inc.
 
Dr. Nwando Olayiwola is the inaugural Chief Health Equity Officer and Senior Vice President of Humana, Inc., a role she commenced in April 2021. Prior to this, she served as the Professor and Chair of the Department of Family Medicine and Chief of Family Health Services at The Ohio State University, where she also founded the Center for Primary Care Innovation and Transformation. She is an internationally renowned board-certified family physician, public health professional, health systems redesign leader, workforce diversity and inclusion champion and primary care transformation pioneer. She is an accomplished health executive with extensive leadership experience. She is a respected innovator and expert in harnessing technology and creative solutions to increase access to care for underserved and disenfranchised populations, health equity, global health system strengthening and primary care redesign, developing strategic partnerships, creating novel and national programs, implementing diversity, equity and inclusion focused programs, physician leadership, clinical medicine and scholarly and creative writing. She is a tireless advocate for women across the globe and contributes to or designs numerous highly impactful programs that improve the lives and health of women. She obtained her undergraduate degree in Human Nutrition/Pre-Medicine at the Ohio State University, Summa Cum Laude and With Distinction, and her medical degree from the Ohio State University/ Cleveland Clinic Foundation. She completed her residency training in family medicine at Columbia University/New York Presbyterian Hospital, where she was a Chief Resident.
 

Lisa M. Gables, CPA


CEO, American Academy of PAs (AAPA)
 
Lisa M. Gables, CPA, was named CEO of the American Academy of PAs (AAPA) in September 2020 after serving as interim CEO since June 2019. Gables has been with AAPA for more than eight years, having served as chief financial officer and chief development officer from May 2012 to September 2020. From May 2012 to July 2015, Gables also served as the executive director of the PA Foundation. Prior to joining AAPA and the PA Foundation, she was the executive director of the American Society of Consultant Pharmacists (ASCP) Foundation and the chief development and program officer of ASCP, where she held similar roles. She is a certified public accountant with a degree in business administration and accounting from the University of Louisville, Kentucky. In addition to her career in aging and health services, Gables serves on the board and as the chair-elect of the American Society on Aging. She is the past treasurer of the Fairfax County Law Enforcement Foundation and currently serves as a volunteer with the Fairfax County Adult Protective Services Agency.
 

PCC Welcomes Two New Executive Members










Array Behavioral Care is the largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities and communities.

The Array clinical team started practicing telepsychiatry in 1999. Founder and current Chief Medical Officer Dr. Jim Varrell provided the nation’s first commitment via telepsychiatry and has since been a leading advocate for the appropriate use of telepsychiatry to increase access to care.

The team’s telepsychiatry service offerings quickly grew into new care settings and new states. The team operated under the name InSight Telepsychiatry and provided services as part of the CFG Health Network. As that was happening, the Regroup Telehealth team formed and began to grow a significant scheduled care presence out of the Chicago area. In 2019, InSight Telepsychiatry and Regroup Telehealth joined forces to form the largest telepsychiatry service clinician organization in the country. In January 2021, the team launched under a new name, Array Behavioral Care.

Facts about Array:
  • Telehealth encounters conducted in 2020: 350,000
  • Behavioral health clinicians hired in 2020: 325
  • Patient net promoter score for 2020: 55




The Catalyst Health Network is a nonprofit health corporation with more than 140 practices in Texas. It is a clinically integrated network of independent physicians who have come together to provide coordinated, high-quality care to patients.

The network takes an approach called the Catalyst Difference, which aims to change health care. Catalyst states: "We are a collection of people willing to pursue any path to transform healthcare, take a stand, and carry the mantle of change. It includes an engaged provider network, value-based contracts that benefit all stakeholders, a systemic approach to care management, and network performance unlike anything else in this part of the country."
 


MedNetOne Health Solutions (MNO) has been a PCC Executive Member since January 2017. The Michigan-based physician organization has more than 900 members and is celebrating its 40th anniversary this year.
 
MNO is intensely community focused, driven by its founding, in part, to create a community for foreign-born private-practice primary care physicians who couldn’t easily access traditional physician organizations. Since then, MNO has been a leader in advancing the development and implementation of advanced primary care initiatives, including the patient-centered medical home, the integration of behavioral health into primary care practices, and the community care travel team, which brings a multi-disciplinary team of clinicians into the physicians’ office or a community setting to provide physician-directed, whole-person care.
 
When the pandemic hit, MNO took immediate action under the leadership of CEO and co-founder Ewa Matuszewski, launching weekly webinars with practices, connecting its members to PPP loan assistance, providing supplies or helping obtain them through the organization’s deep network of healthcare and community resources, and ultimately creating a back-to-work playbook and video (the latter with financial assistance from Blue Cross Blue Shield of Michigan) to educate both practices and the broader business community on easing safely to a new normal work or primary care setting. 
 
Matuszewski, an immigrant of Polish descent, is drawn to finding solutions to challenges the healthcare system can pose for immigrants and non-native English speakers. When the COVID-19 vaccines became available, she identified a need to increase vaccinations in the Greater Detroit Asian community. Holding pop-up vaccination clinics run by its clinical teams, member physicians and local pharmacy students, MNO reached the Filipino, Korean, Chinese, Hmong, Thai and Vietnamese communities and then established clinics at area middle and high school parking lots to reach students aged 12 to 17.
 
Committed to raising awareness of the role social determinants of health (SDOH) play in comprehensive wellness, MNO extended its existing reach in academic circles to co-launch an annual #SDOH symposium with the nearby Oakland University School of Health Sciences, where Matuszewski chairs the school’s advisory board. Matuszewski also offers implicit bias training to physicians and other healthcare community professionals.   
 
The pandemic, despite its many tragic losses, presented the opportunity for physician organizations like MNO to show the depth of their resources to heal, to offer solutions to complex and multi-pronged problems, and, above all, to profoundly and positively impact their community.
 

Join the Ranks of PCC Executive Members
The two articles above illustrate the type of organizations that are PCC Executive Members and the diversity of stakeholders that participate in the important work of PCC. The PCC needs and welcomes other leading organizations like yours that are dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home.

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 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
 

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.

Crystal Eubanks

 
Senior Director, Care Redesign and the California Quality Collaborative at Purchaser Business Group on Health
 
Why are you passionate about primary care?
 
I am, first and foremost, a social justice advocate. Improving access to and quality of primary care in our communities is a positive action toward reducing inequalities and inequities. Living for two years as a Peace Corps volunteer in an indigenous Amazon community showed me the power of health, or more accurately, the lack of wellness, to shape lives from birth and perpetuate inequity from one generation to the next. We can build schools, but if the children are too sick to attend, what’s the point? Primary care is needed, and not only is it the first and most effective response to illness, but it is built on relationships – between people and clinicians, among care teams – and it is the power of being in community that enables healing and wellness. Every day that I work to strengthen primary care is my contribution to the social justice fight.

 
If you had a magic wand that you could wave to change one thing in primary care, what would it be?
 
Pay for outcomes. Align financial incentives with our expectations throughout the healthcare system. It is wholly unfair to push change on care teams, expect them to take on the work of change on top of the day-to-day care of our communities, and not make the right choice the easiest choice by also changing the way they are paid. More often than not, the care teams I have worked with want to improve quality, want to transform, and know what needs to be done. Their limitation is resources. I find it patronizing and paternalistic for the powers that be to toss out scraps of money to “educate: them instead of putting their money where their mouth is because the real investment needed is structural change in the system that can only be achieved by aligning business incentives with our expectations in parallel to supporting care teams in operationalizing the changes.

 
What one thing about your work do you want people working outside primary care to know or understand?

Clinicians, patients, and purchasers want the same things and want to do the right thing now more than ever. The images of COVID-19 were in hospitals and mass testing and vaccination sites; what most didn’t see was its brutal impact on primary care and the challenge to its continued existence. I witnessed the resiliency of care teams to pivot quickly and, when given the permission to innovate and a sense of urgency, to adapt care to meet patients’ and care teams’ needs. A resilient primary care system strengthens the resiliency of our communities, our families.
 
Looking back on your career, what’s the most significant contribution to primary care that you or your team have made?

I was fortunate to work among an amazing team of changemakers throughout California from 2016 to 2019 on CQC’s Practice Transformation Network through the CMS Transforming Clinical Practice Initiative. We worked to engage almost 5,000 clinicians across 2,000 practices touching 3 million Californians. That’s more than the entire population of 17 states! We worked tirelessly to build relationships throughout the state, within delivery organizations and between them, and achieved 20% relative improvement across the network and a 10 to 1 return on investment through $186 million in cost-savings to the system. Knowing that 40,000 people experienced improved diabetes care from our efforts brings me the joy in work that we strive to build among primary care teams. Never underestimate the power of relationships to make lasting change.
 
 

 PCC Welcomes Two New Staff Members
The PCC is pleased to have these two new members join its staff:
 

Noah Westfall, MPH


Program Coordinator
 
As PCC’s new program coordinator, Noah supports its policy work and grant projects.
 
Prior to joining PCC, Noah served as a Presbyterian Church (USA) Young Adult Volunteer in Austin, Texas. He lived in intentional community with other volunteers and worked with Texas Impact, an interfaith advocacy organization. He engaged on a range of policy topics including Hurricane Harvey recovery, climate change and immigration. He went on to complete a master's in public health with a concentration in health policy from George Washington University. He worked as a graduate research assistant with the Mullan Institute for Health Workforce Equity, supporting several Health Resources and Services Administration-funded research projects related to health professions education.
 
Noah graduated from Santa Clara University with a bachelor's degree in philosophy.
 


Larry McNeely II



Policy Director (starting July 12)
 
Larry is well-known in the primary care community. He most recently worked as the Chronic Disease Policy Coordinator for the Maryland Department of Health’s Center for Chronic Disease Prevention and Control in Baltimore. Prior to that, he held policy director positions at the American Diabetes Association in Arlington, Va., and the National Coalition on Health Care in Washington, D.C.
 
He has a Master of Public Administration from West Virginia University, Morgantown, and comes to the PCC with many years of experience in driving policy change and expertise in value-based payment models, Medicare, Medicaid, health equity, USDA nutrition programs, and chronic disease prevention.
 

 Join PCC's New Journal Club!

First, some background: 
 
PCC has started a new project, Bridging the Gap in Primary Care Research, funded by a Patient-Centered Outcomes Research Institute Eugene Washington PCORI Engagement Award (19760-PCPCC). This effort helps front-line primary care clinicians, consumers, advocates, payers and policymakers identify, share and engage with relevant primary care-based research.
 
As part of the project, we have formed two groups: the Journal Club and the Research Dissemination Workgroup, which is creating a curated list of 25  recent, seminal primary care clinical and health services research articles. PCC will also create a resource hub on our website to share relevant health services and clinical research more widely. 
 
Join the Journal Club
 
This group is open to all PCC members and supporters who are interested in learning about and engaging in conversation about primary care’s research and well developed evidence base. 
 
The club will evaluate articles identified by PCC’s new Research Dissemination Workgroup (described below) for academic rigor and potential impacts. It will also act as an adviser to the research group to convey the most salient research findings for stakeholders with a variety of perspectives and research needs. The club, scheduled to meet quarterly, will provide input into PCC’s research dissemination work.
 
The club will start work this summer, with these exciting parts of the group in place:
 
Who: The club will be led by these two leaders in primary care as co-chairs:   When: The club’s first meeting will be on July 22, 1:00-2:00 p.m. ET.  

What: At its first meeting, the club will discuss these two articles:  
  • Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015, by Sanjay Basu, MD, PhD; Seth A. Berkowitz, MD, MPH; Robert L. Phillips, MD, MSPH; Asaf Bitton, MD, MPH; Bruce E. Landon, MD, MBA; Russell S. Phillips, MD
  • Primary Care Practices Providing a Broader Range of Services Have Lower Medicare Expenditures and Emergency Department Utilization, by Eugene C. Rich; Ann S. O'Malley; Claire Burkhart; Lisa Shang; Arkadipta Ghosh; Matthew J. Niedzwiecki. J Gen Intern Med. 2021 Mar 29. doi: 10.1007/s11606-021-06728-2
The first authors of each article (Basu and Rich) will be part of the meeting to present their papers.
If you are interested in joining, please fill out this Google form.
If you have responded to a previous invitation to the Journal Club, you do not need to respond again; we have your information and will be contacting you soon.
  
Questions?
 
For more information about the overall project or Journal Club, contact Noah Westfall.
 

PCC Webinars

Register now for our July webinar!
Monday, July 12, 2021
2:00 p.m. ET
The Primary Care Collaborative will host a conversation with special guests from the White House and state government, who will talk about the role of primary care in the administration of and education on the COVID vaccines. They will also discuss the strategies the Biden-Harris administration and state public health departments have used to boost confidence in the vaccines and help Americans get vaccinated, from the administration’s Month of Action in June to state innovations such as involving barber shops in vaccine outreach. The U.S. has not reached its vaccination goals yet, and this discussion will provide some insights on how we can get there by leveraging primary care.
Register now
Cost: free
The webinar will be recorded and available on PCC's website within 24 hours following the conclusion of the webinar.

Most Recent Webinars

 

Recommendations on Increasing the Uptake of Shared Decision-Making in Integrated Behavioral Health Care

June 16, 2021
This webinar focused on new PCC recommendations—ways to increase the adoption of shared decision-making (SDM) in integrated behavioral health care—informed by a literature review and the expert input of leaders across multiple stakeholder groups.

SDM is much less prevalent in the behavioral health space as compared to medical settings, potentially contributing to patient mistrust and poorer behavioral health outcomes. Presenters on this webinar will summarize the recommendations and discuss the implications for practices, policymakers, consumer advocates, employers and others interested in furthering SDM in integrated practices.

The effort was funded by a Eugene Washington PCORI Engagement Award for Community Convening. 

Presenting the recommendations: Michelle Dirst, MA, Director, Practice Management and Delivery Systems Policy, American Psychiatric Association

Panelists:

  • Renée Markus Hodin, JD, Deputy Director, Center for Consumer Engagement in Health Innovation, Community Catalyst
  • Shawn Griffin, MD, President and CEO, URAC
  • Jared Skillings, PhD, ABPP, Chief of Professional Practice, American Psychological Association

Moderator: Louise Probst, MBA, Executive Director, St. Louis Area Business Coalition

The National Academies of Sciences, Engineering, and Medicine’s New Report on Primary Care: Recommendations and Reactions

May 13, 2021
On May 4, the National Academies of Sciences, Engineering, and Medicine released its new report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. The report looks at the state of primary care today and presents an implementation plan that builds upon the recommendations of the Institute of Medicine’s report from 25 years ago: Primary Care: America’s Health in a New Era (1996). A co-chair of the committee that wrote the new report summarized its major findings and recommendations. A diverse set of leaders then reacted and discussed how the primary care community can leverage this report to accelerate reform.

Presenter of the findings and recommendations of the report:

Bob Phillips, MD, MSPH, Founding Executive Director | The Center for Professionalism & Value in Health Care, American Board of Family Medicine Foundation; Co-Chair of the committee that produced the report

Reactors:
  • Patrick Conway, MD, MSc, CEO | Care Solutions, Optum
  • Sinsi Hernández-Cancio, JD, Vice President for Health Justice | National Partnership for Women and Families
  • Kavita Patel, MD, MS, Nonresident Fellow | The Brookings Institution
Moderator: Ann Greiner, MCP, President and CEO | Primary Care Collaborative

 
Watch past webinars
 

PCC Develops Recommendations on Shared Decision-Making in Behavioral Health Care
PCC has produced a new set of recommendations on increasing the uptake of shared decision-making (SDM) in integrated primary care-behavioral health settings. The recommendations, presented in a briefing paper, are the product of a 2020-2021 PCC project funded by a Eugene Washington PCORI Engagement Award for Community Convening.
 
SDM is much less prevalent in the behavioral health space as compared to medical settings. This can limit patients’ ability to be engaged in decisions about their care and may contribute to patient mistrust and poorer behavioral health outcomes.
 
PCC undertook this project to bring its learnings about SDM in the medical realm to integrated behavioral health settings and to leverage the expertise and backgrounds of leaders within our membership and in the broader primary care community.  
 
PCC began this effort by reviewing the existing research literature at the intersection of primary care and behavioral health. PCC produced a summary of 80 articles on SDM in integrated care. PCC then assembled and hosted a roundtable of expert leaders from diverse stakeholder groups that leveraged our relationships in both behavioral health and primary care as well as our knowledge of how to engage patients and clinicians in shared decision-making. The roundtable reviewed the evidence summary before its gathering, which informed its four recommendations:
  1. Shift the culture to support SDM in all aspects of care to increase equity and reduce stigma.
  2. Build on the existing primary care infrastructure and learnings and enhance training.
  3. Advocate for prospective payment models that incorporate SDM, beginning with a shared definition and related measures.
  4. Further develop the SDM evidence base as it relates to outcomes, experience of care, and satisfaction.
In PCC's June webinar, the recommendations were presented, and a diverse panel of experts discussed the application of the recommendations to patients, practices and policy. Watch the recording of the webinar.
Read/download “Recommendations on Increasing the Uptake of Shared Decision-Making in Integrated Behavioral Health Care”
 

Visit the Improved Advocacy & Policy Section on the PCC Website

We’ve made the Advocacy and Policy section of the PCC website easier to use. The whole section, but especially the primary care investment subsection, has received a house cleaning and rearrangement to make information easier to find. There are now five clear subsections: Be sure to visit this section regularly to stay abreast of PCC’s advocacy and policy work.
 

GTMRx National Task Force Produces New Report and Recommendations: Building Vaccine Confidence in the Health Neighborhood
The immunization rate for the COVID vaccines is slowing across the U.S. Building confidence in the vaccines to boost uptake is urgent, says a new report from the bipartisan GTMRx National Task Force focused on building vaccine confidence in the health neighborhood. The task force, made up of leaders in health care, public health and academia, and which included Ann Greiner, PCC’s president and CEO, calls on communities across the nation to create grassroots organizations called Vaccine Confidence Leagues, which can mobilize trusted messengers from those communities to address individuals’ concerns and boost vaccine confidence and uptake.

Read the report.
 

New Articles, Research & Resources


Article: Transforming Health Care to Address Value and Equity: National Vital Signs to Guide Vital Reforms

June 24 Viewpoint piece on JAMA Network
by Kevin Fiscella, MD, MPH; Mechelle R. Sanders, PhD; Jennifer K. Carroll, MD, MPH
“The US health care system is failing to deliver value and equity. Life expectancy has been declining nationally. Health care costs in the United States are the highest in the world. Medicare alternative payment models have yielded modest reductions in costs but have generally not improved health or equity. Fundamental change is needed beyond redesign of alternative payment models. Health care must embrace equitable improvement in the national Vital Signs initiative, invest in primary care, and collaborate with communities.”
 

Research: Access to Care, Cost of Care, and Satisfaction With Care Among Adults With Private and Public Health Insurance in the U.S.

By Charlie M. Wray, DO, MS; Meena Khare, MS; Salomeh Keyhani, MD, MPH

Importance: Contemporary data directly comparing experiences between individuals with public and private health insurance among the 5 major forms of coverage in the U.S. are limited.

Objective: To compare individual experiences related to access to care, costs of care, and reported satisfaction with care among the 5 major forms of health insurance coverage in the U.S.

Design, Setting, and Participants: This survey study used data from the 2016-2018 Behavioral Risk Factor Surveillance System on 149,290 individuals residing in 17 states and the District of Columbia, representing the experiences of more than 61 million U.S. adults.

Conclusions and Relevance: In this survey study, individuals with private insurance were more likely to report poor access to care, higher costs of care, and less satisfaction with care compared with individuals covered by publicly sponsored insurance programs. These findings suggest that public health insurance options may provide more cost-effective care than private options.
 

Research article: Cultural And Structural Features Of Zero-Burnout Primary Care Practices 

By Samuel T. Edwards, Miguel Marino, Leif I. Solberg, Laura Damschroder, Kurt C. Stange, Thomas E. Kottke, Bijal A. Balasubramanian, Rachel Springer, Cynthia K. Perry and Deborah J. Cohen
Although much attention has been focused on individual-level drivers of burnout in primary care settings, examining the structural and cultural factors of practice environments with no burnout could identify solutions. In this cross-sectional analysis of survey data from 715 small-to-medium-size primary care practices in the United States participating in the Agency for Healthcare Research and Quality’s EvidenceNOW initiative, we found that zero-burnout practices had higher levels of psychological safety and adaptive reserve, a measure of practice capacity for learning and development. Compared with high-burnout practices, zero-burnout practices also reported using more quality-improvement strategies, more commonly were solo and clinician-owned, and less commonly had participated in accountable care organizations or other demonstration projects. Efforts to prevent burnout in primary care may benefit from focusing on enhancing organization and practice culture, including promoting leadership development and fostering practice agency.
 

Blog posts: A Decade of Value-Based Payment: Lessons Learned And Implications For The Center For Medicare And Medicaid Innovation

Part 1 | Part 2
On Health Affairs on June 9 and 10; by Hannah L. Crook, Robert S. Saunders, Rachel Roiland, Aparna Higgins and Mark B. McClellan
The results of the past decade of value-based payment (VBP) model implementation have provided mixed evidence of the impacts of these reforms, and questions about how payment and care reforms can best improve quality, outcomes, and the care experiences of patients. The years of reform experience, recent trends, plus a new Administration that has expressed a commitment to effective payment reform have led to a number of thoughtful assessments of how to proceed from here. In a two-part post, the authors reflect on “lessons learned” from the evidence gained from the past decade and beyond to promote the effectiveness of APMs. They describe the implications for future VBP efforts and the implications for the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI).

 

Resource: New Tool Helps Primary Care Practices Assess Patients’ Social Needs

The Agency for Healthcare Research and Quality (AHRQ) has developed a new tool to help primary care practices screen and refer patients to address their unmet social needs, such as access to adequate food and housing. The resource is part of AHRQ’s efforts to help practices provide care that takes into account social determinants of health. It is included among the agency’s Tools for Change, a set of resources developed as part of AHRQ’s EvidenceNOW: Advancing Heart Health Initiative. The tool helps practices find resources on patient screening and referral, consider what approaches work best for their practice and understand how to use collected information to address patients’ social needs, tailor their care and maximize reimbursement.
 

Blog post: All-Payer Spread of ACOs And Value-Based Payment Models In 2021: The Crossroads And Future Of Value-Based Care

On Health Affairs, June 17; by David Muhlestein, William K. Bleser, Robert S. Saunders and Mark B. McClellan
Now that the pandemic is starting to wane, concerns about health care spending are returning. We are now at a point where the Medicare Trust Fund is closer than ever to exhaustion, while enrollment in Medicare and Medicaid has continued to grow. Prior to the pandemic, experts estimated that Medicare expenses would grow more than 7 percent in 2020. Value-based payment models continue to be viewed as mechanisms to address rising health costs.


Study: Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations

Published online in the Journal of Primary Care & Community Health on June 14

Objectives: To evaluate the prevalence of social determinants of health (SDoH) factors in a large commercially-insured population and to characterize the prevalence of common conditions (eg, diabetes, behavioral health issues) and addressable health services utilization concerns (eg, lack of preventive care) for which employers offer no- and low-cost benefit programs.

Results: Twenty-seven percent of this commercially-insured population live in a zip code where the median income is at or below 200% of the Federal Poverty Line. Respondents identified cost (55%) and family, school, or work responsibilities (26%) as key barriers to care. ER overutilization rates are higher in lower income zip codes than wealthier zip codes (34% vs 9%) as is the prevalence of diabetes, overweight/obesity, and behavioral issues, and decreased use of preventive services. Fifteen percent of the study population live in a low-access food area. There is considerable variability in access to employer-sponsored resources to address these needs (70% of employers provide behavioral health programs; 63% provide telehealth programs, but only 1% offer healthy food programs and less than 0.5% offer either child care or transportation support programs).
 

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.
 

Sustainability Beyond Relief: Bolstering our First Line of Care
 

July 7, 2021, 12:00-1:00 p.m. ET
Online briefing by the Alliance for Health Policy
The COVID-19 pandemic has shaken up all facets of the U.S. healthcare system and has forced us to rethink our approach to our first line of health care, including public health departments, community health workers, community health clinics, and primary care practices. During this final stretch of the pandemic, COVID-19 continues to blur the lines between traditional public health actions and those completed by the primary care system, such as contact tracing, vaccine deployment, and the need to build trust and develop messages specific to target populations.
 
During this briefing, you will learn about:
  • The opportunities and challenges that have arisen for first-line providers
  • The role of data sharing, payment systems, and workforce provisions\Long-term policy options to ensure COVID recovery resources are consistent with the broader aim of creating a more resilient public health and primary care infrastructure
 Panelists include Ann Greiner, PCC’s President and CEO.
 
 

Understanding the Impact of a Public Health Crisis on Physical and Behavioral Healthcare Providers; HHS Region 8

Hosted by the Mountain Plains Mental Health Technology Transfer CenterProviding physical or behavioral health care to others during the pandemic can lead to increased levels of stress, fear, anxiety, burnout, frustration, and other strong emotions. It is imperative that physical and behavioral health care clinicians recognize personal signs of mental fatigue, are given supports in their organization to ensure continued productivity and quality care,  and are provided with tools to learn how to cope and build resilience. This training series has been developed to encourage self-care and to assist in building resilience.

Access the free toolkit: Building Resilience Among Physical and Behavioral Healthcare Providers During a Global Health Pandemic

Registration is free and required. The series is available for individuals residing in Health and Human Services (HHS) Region 8 (CO, MT, ND, SD, UT, and WY). Remaining session:
  • Session Four: Promoting Resiliency at an Organizational Level
    July 7, 2021 | 11:00 a.m.-12:00 p.m. MT/12:00 p.m.-1:00 CT

 

Experiential Ways to Build Up Your Mental Health and Resilience


July 21, 2021, 12:00-1:00 p.m. MT
Hosted by the Mountain Plains Mental Health Technology Transfer CenterRegistration is free and required. This session is available to individuals residing in HHS Region 8 (CO, MT, ND, SD, UT, and WY). Certificates of attendance will be available.

This training focuses on improving mental health wellness by teaching participants to recognize when they are thriving or languishing and provides skills and strategies for building and increasing resilience. Christina Ruggiero will give an overview of the foundations of mental health wellness and guide participants through exercises that support self-reflection, relaxation, and the development of a personalized self-care plan. Christina will close the session by reviewing additional resources that participants can use to establish self-care strategies to cope with uncontrollable events.  

This hour is to help you focus on YOU and how YOU are doing. Visit the Mountain Plains MHTTC provider well-being resources page for additional self-care resources.

After attending this session, participants will: 
  1. Understand the difference between Thriving Mental Health and Languishing Mental Health.
  2. Recognize the significant role mental health plays in overall health and well-being.
  3. Have practiced and become familiar with exercises to improve mental health using relaxation and self-care.  
  4. Develop self-care strategies to help manage COVID-19 uncertainty.

 
Creating Ecosystems of Health Symposium Series

In an effort to advance lifestyle medicine at a systems level, the American College of Lifestyle Medicine is offering two one-day virtual symposia that address the integration of health restoration into health systems and academic settings. Remaining session:
  • Equipping the Next Generation, July 21, 11:00 a.m.-6:00 p.m. ET
 

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