Colorado’s Division of Insurance is nearing work to finalize a new primary care investment regulation (“Strategies to Enhance Health Insurance Affordability”) that proposes to increase primary care investment in the state by one percentage point in 2022 and 2023. The proposal also includes new alternative payment model (APM) spend targets, including requiring 25% of payments to primary care to be made prospectively by the end of 2022. A rulemaking hearing was held in October.
In October, the PCC submitted a comment letter to CMS on the agency’s proposed CY 2021 Medicare Physician Fee Schedule (MPFS). The letter voiced strong support for the proposed rule as a way to “move toward fundamentally correcting the longstanding undervaluation of primary care services by retaining increases to office-based Evaluation & Management (E/M) services finalized in the CY 2020 MPFS." It also acknowledged that increased investment was essential—though not sufficient—to achieving high-performing primary care and that it must also be accompanied by rapid movement toward global payments that are prospective and comprehensive. The proposed 2021 fee schedule is facing pushback from specialists who will see a cut to their pay to offset these E/M increases. Over 200 House Members sent a bipartisan letter to House leadership this month calling for Congress to address the cuts posed by a budget-neutrality rule for Medicare.
New data show that 49% of Black Americans would not take a coronavirus vaccine, even it was “deemed safe by scientists and freely available.” The survey, a joint effort by the Kaiser Family Foundation and ESPN’s The Undefeated, explores public views on health care and was answered by over 1,750 U.S. adults, with an oversampling of Black adults. Communities of color have been disproportionately impacted by the pandemic: Black and Latino adults are three times as likely as White adults to be infected with COVID-19 and twice as likely to die. Yet long-held mistrust of the healthcare system, on top of underrepresentation in vaccine clinical trials, is leading to vaccine safety concerns among these communities. (Whereas the survey finds that White respondents who would decline the vaccine where more likely to say they don’t think they need it.) The PCC’s Policy Committee explored these topics with guest speaker Tammy Boyd of the Black Women’s Health Imperative (BWHI) at its October meeting. BWHI is a PCC Executive Member.
The Trump administration announced an extension of the coronavirus public health emergency (PHE). The renewal went into effect Oct. 23 and will last for 90 days, expiring in January. The PHE allows for the extension of several policies including telehealth flexibilities and more funding (6.2 percentage point FMAP increase) for state Medicaid programs during the pandemic. This is the third extension of the emergency declaration.
A new Democratic staff report from the Senate Committee on Health, Education, Labor, and Pensions (HELP) highlights racial disparities related to COVID-19 and calls on Congress to take action to address racism and inequality in the U.S. healthcare system. Among the report’s recommendations is the call to “provide robust investments in primary care programs and support the expansion of the health care workforce in communities of color.” It also calls for expanded testing and contact tracing, as well as a “clear plan for equitably distributing a vaccine when one becomes available.”
On Oct. 2, Pennsylvania's Gov. Tom Wolf (D) signed Executive Order 2020-05, establishing an Interagency Health Reform Council to "to evaluate the potential alignment of Commonwealth health care payment and delivery systems to provide efficient, whole-person health care that also contains costs, reduces disparities, and achieves better health outcomes for Pennsylvanians." Part of the council's responsibilities include setting spending targets for primary care and behavioral health to promote whole-person care in the commonwealth. The first report of healthcare reform recommendations is to be submitted by the end of this year, with cost growth benchmarks set by March 2021.
On October 2, 2020, Pennsylvania's Gov. Tom Wolf signed Executive Order number 2020-05, which establishes the Interagency Health Reform Council to "to evaluate the potential alignment of Commonwealth health care payment and delivery systems to provide efficient, whole-person health care that also contains costs, reduces disparities, and achieves better health outcomes for Pennsylvanians." Part of the Council's responsibilities include setting spending targets for primary care and behavioral health to promote whole-person care in the state. The first report of health care reform recommendations is to be submitted by December 31, 2020.
On October 7, 2020, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American College of Physicians (all Executive Members of the PCC) held an online congressional briefing titled Primary Care in Crisis: How Congress Can Support Patients and Practices During and After COVID-19. The briefing included frontline primary care physicians speaking about their experiences and challenges in meeting their patients’ needs during the COVID-19 pandemic, a patient's perspective on the importance of primary care to their family’s health, and how Congress can support primary care in 2020 and beyond.
View the recording of the briefing.
Read the joint statement summarizing those organizations' requests of Congress.
The PCC sent a letter today to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to voice its strong support of CMS’s proposed Medicare Physician Fee Schedule (MPFS) for calendar year 2021. The letter stated that the "proposed MPFS moves toward fundamentally correcting the longstanding undervaluation of primary care services by retaining increases to office-based Evaluation & Management (E/M) services finalized in the CY2020 MPFS and set to take effect this January." The PCC also stated that the increased investment was essential—though not sufficient—to achieving high-performing primary care and that "it must also be accompanied by rapid movement toward global payments that are prospective and comprehensive."
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.
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