Federal Policy Updates

• American Academy of Pediatrics released a new study that found that over 140,000 children experienced the death of a parent or grandparent caregiver during the COVID-19 pandemic and the risk of losing a caregiver was much higher for children of racial and ethnic minorities.
• Health plans are taking on a larger role in addressing the social drivers of health to achieve health equity. In a report published in September, the Anthem Public Policy Institute explored the affordable housing crisis in California, with a focus on patients experiencing homelessness. The report discusses how Medicaid managed care plans can partner with states to provide resources for individuals experiencing homelessness. Additionally, Humana recently invested $25 million as part of a broad population health campaign to support affordable housing initiatives. PCC board member Dr. Nwando Olayiwola, Chief Health Equity Officer at Humana, said, “Humana is committed to addressing structural and root cause barriers to good health outside of the clinical setting, such as access to healthy food, transportation, social connections and stable housing, to help eliminate unjust differences in health.”
• In a new paper titled “Health Care for Our Nation's Veterans: A Policy Paper From the American College of Physicians,” the American College of Physicians (ACP) advocates for the patient-centered medical home model for primary care delivery in the Veterans Health Administration by sustaining and strengthening the Patient-Aligned Care Team (PACT) model.
• On Oct. 7, the National Partnership for Women and Families along with over 50 other reproductive justice and Black policy leaders signed a letter to democratic congressional leadership urging them to commit to extending postpartum Medicaid coverage to 12 months and include other equity-focused provisions found in the Black Maternal Health Momnibus Act of 2021 (H.R. 959) in the reconciliation process.
• On Oct. 13, a number of PCC Executive Members (including American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, Catalyst Health Network, and One Medical) signed on to a letter to executive leadership at the White House and HHS to include primary care physician practices in the ongoing COVID-19 vaccine rollout.
• A partnership among Covered California (California’s ACA marketplace), California Public Employees’ Retirement System (CalPERS) and PCC Executive Member Purchaser Business Group on Health (PBGH) will launch a pilot program beginning in 2022 to test practice-level measurement using 11 advanced primary care measures developed by the California Quality Collaborative. 

Congress has turned its attention to a budget reconciliation package (H.R. 5376, Build Back Better Act).  After tough intra-party negotiations, Democrats are now contemplating legislation with between $1.5 and $2.0 trillion. The pressure to limit the bill’s expenditures may pit congressional Democrats against each other over health-related provisions, such as expanding Medicaid to low-income adults in all states, extending American Rescue Plan Act marketplace subsidies, and expanding Medicare benefits to include vision, dental, and hearing. Although these issues may be addressed, health care is not the focus of the bill.
 
During PCC’s Oct. 19 Policy and Advocacy meeting, Jennifer Bell from Chamber Hill Strategies provided insight on the status of the reconciliation bill as it relates to health provisions. Bell expects activity to likely center around strengthening the Affordable Care Act and expanding Medicaid coverage. There are also several critical healthcare provisions that are not included in the current reconciliation negotiations, including telehealth.
 
Democrats feel there is an opportunity to make significant progress and feel tremendous pressure to deliver on campaign promises with this reconciliation package. However, debates have grown as Democrats consider cutting funding for Medicare Advantage to pay for portions of the bill. Additionally, according to Bell, there is a real possibility that the package could fail as deadlines rapidly approach and a lack of trust and sense of urgency stall necessary action on expiring provisions, which include surface transportation funding, the debt ceiling, and the child tax credit.

WASHINGTON, Oct. 20, 2021—Following is a statement by Ann Greiner, president and CEO of the PCC, on the release today of The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMS Innovation Center/CMMI) “Driving Health System Transformation – A Strategy for the CMS Innovation Center’s Second Decade.”

"CMS Administrator Chiquita Brooks-LaSure, Deputy Administrator and Center for Medicare & Medicaid Innovation (CMMI) Director Elizabeth Fowler and the CMMI team have laid out a bold vision and strategy for how to continue transforming the U.S. health system through innovation and a focus on equity, and strong investments in comprehensive, whole-person primary care are crucial to its success.
 
"By 2030, CMS calls for most Medicare and Medicaid beneficiaries to be in longitudinal, accountable-care relationships, which are foundational to primary care. CMS envisions new advanced primary care models for 2023 and beyond as well as further support for smaller and independent practices to foster transformation.
 
"Centering health equity, the CMS Strategy Refresh insists that the benefits of innovation reach underserved and rural communities that have often been left out in the past. 
 
"The Primary Care Collaborative looks forward to working with CMS/CMMI on the concrete steps to realize this exciting vision."

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Ann Greiner, Primary Care Collaborative president and CEO, is available for further comment and interviews. To arrange an interview, contact:
Stephen Padre
Communications Manager, Primary Care Collaborative
[email protected]
202-417-3911