Federal Policy Updates

Primary care payment models out of the Center for Medicare and Medicaid Innovation have seen a number of updates in recent weeks. Practices that joined the Comprehensive Primary Care Plus (CPC+) model in 2018 recently learned that their fifth year of the model (anticipated for 2022) would be canceled. The CPC+ program will now end for all practices on December 31, 2021.
 
Separately, application deadlines for the Primary Care First model were extended: Practices interested in joining Cohort 2 should apply by May 21; payers have until June 18. While CMMI announced the 53 organizations participating in the Global and Professional Direct Contracting Model’s first performance year (which began April 1), it also announced that it would not be opening applications for 2022 as originally planned. Previously, the Geographic Direct Contracting model had also been put on hold while under review.

COVID-19 continues to take a disproportionate toll on communities of color. A recent study found that Black women are three times more likely than White men to die from COVID-19. And this month, the CDC released a pair of studies further highlighting the pandemic’s inequities, finding that Hispanic and Latino patients made up the highest proportion of hospitalized patients with COVID-19 across all four census regions. A new West Health/Gallup survey of Americans found that nearly one in five skipped health care over the last year because of cost concerns; Black adults (29%) were almost twice as likely to not afford care as compared to White adults (16%). The administration is responding, in part, by targeting funds to Community Health Centers and other locations that serve more low-income patients.
 
In early April, HHS expanded its COVID-19 vaccine program to all health centers—nearly 1,500—and Tuesday announced $1 billion for health centers to make COVID-19 related capital investments. HHS also recently announced $145 million for health center lookalikes (community-based practices that meet Health Center Program criteria but are not grantees) to respond to and mitigate the spread of COVID-19 while expanding vaccination efforts.

The PCC sent a letter to the chair and ranking member of the U.S. Senate Labor, Health and Human Services, Education and Related Agencies Subcommittee and the chair and ranking member of the U.S. House of Representatives Labor, Health and Human Services, Education and Related Agencies Subcommittee on April 26 requesting dedicated funding for the Agency for Healthcare Research and Quality's (AHRQ) Center for Primary Care Research in fiscal year 2022. The center, authorized by statute in 1999 but never expressly funded, offers to contribute important knowledge to the delivery of high-quality primary care at a time when such insights are essential to the long-term health of the nation.

Read the letter.

The Biden-Harris administration has appointed several officials to health policy positions that may impact primary care. These include Xavier Becerra, who was confirmed as the first Latino Secretary of the Department of Health and Human Services, and Rachel Levine, who was confirmed as Assistant Secretary for Health in HHS and is the first openly transgender federal official confirmed by the Senate. Vivek Murthy, the former Surgeon General under Barack Obama, was re-confirmed to fill the role again. Read PCC’s letter of support for him that asserts he brings experience, vision and evidence-based sensibility to help the country through the COVID-19 pandemic and beyond. Elizabeth Fowler, most recently of the Commonwealth Fund and a former PCC board member, was selected to lead the Center for Medicare and Medicaid Innovation (CMMI). Biden named Chiquita Brooks-LaSure, a former federal policy official now with Manatt Health, as his nominee for CMS Administrator.