Federal Policy Updates

For Media Inquiries: Edward Walrod, Senior Communications Manager, PCC, ewalrod@thepcc.org   
 

As State Legislators Gather, PCC Launches New Primary Care Investment Information Hub 
 

January 17, 2023 (Washington, D.C.)- With state legislatures gaveling in across the country, the Primary Care Collaborative (PCC), with support from the Milbank Memorial Fund, launched a new web-based State Primary Care Investment Hub - a collection of information and analysis to help state care advocates, researchers, and officials reorient their states’ health systems towards primary care. 

The site’s new searchable web tool includes a growing number of states – 8 coming online in 2022 and now numbering nearly two out of five -- that have recently passed legislation or taken administrative action to measure and/or enhance primary care investment. PCC, a nationwide, multi-stakeholder non-profit, non-partisan membership organization, sees an opportunity for further progress in state Capitols. As recently as 2018, just two states had passed such legislation, Oregon and Rhode Island. 

“Evidence from a 2021 National Academies of Science, Engineering, and Medicine report makes it crystal clear: primary care is the only part of the health system where more investment results in better population health and more equity,” said Ann Greiner, President & CEO of the Primary Care Collaborative. “State policymakers that invest in primary care are investing in an evidence-based solution to many of their and our current health care challenges.”  

The new web tool, available through PCC’s homepage, will act as a hub for policymakers, advocates, researchers, and primary care providers, with access to original PCC research, published primary care investment reports from states, and updates on legislation introduced around the country. PCC also organizes regular calls with stakeholders and policymakers on this issue. 

For primary care practices and communities buffeted by overlapping epidemics, recent state-level progress is welcome, according to PCC Director of Policy, Larry McNeely. “2023 will bring new momentum if states look at the evidence. They will find that primary care is foundational to health in all communities It is an exciting time for primary care investment.” 

Advocates and state officials alike can access this tool and all the information about this growing trend --- embraced by blue and red states alike: https://www.pcpcc.org/primary-care-investment   

Accessing information about primary care has never been easier or faster! Scan here:  

On December 8th, the Primary Care Collaborative and its Better Health - NOW Campaign backed key elements of draft Senate Finance mental health integration and workforce proposals.

In the U.S. today, the specialty behavioral health delivery system is overwhelmed by increasing suicide rates, accelerating rates of substance use disorder deaths, and a tripling in the prevalence of depressive symptoms since the beginning of the pandemic. Moreover, noted disparities in mental health by age, rurality, and economic circumstances exist alongside other alarming trends by racial/ethnic group. In 2019, suicide was the second leading cause of death for Black individuals aged 14-24.

Contributing factors to suicide among Blacks may include untreated mental illness and continued exposure to violent crime, violence, and accumulated trauma. Suicide rates are higher for American Indian/Alaska Native populations compared to other racial groups, and those rates have increased since 2010. In another dimension of the crisis, age-adjusted rates of drug-induced deaths among the Black population not only matched but exceeded rates among the white population in 2019, after a decade in which those rates had been largely lower than whites.

Leveraging team-based primary care that includes behavioral health integration is fundamental to addressing today’s mental health and addiction crises and the nation’s future health. Today, more mental health care is rendered in the primary care setting than anywhere else, including the mental health care sector, continuing a trend that has existed for four decades.

Therefore, we applaud the Finance Committee’s bipartisan work toward a comprehensive response to America’s behavioral health crises and support the provisions identified here.

PCC joined more than 800 health care associations, accountable care organizations (ACOs), medical practices, and health systems to urge Congressional leaders to extend incentive payments meant to encourage participation in risk-bearing alternative payment models (APMs), in a letter released on September 28, 2022. Those incentives expire at the end of the year unless Congress acts.

Congress in 2015 created a 5 percent incentive payment to support  new payment models. While there are nearly 300,000 clinicians expected to receive the incentive this year, that number is far below Congressional expectations when the incentives were established. Therefore, the letter calls on lawmakers to extend the incentives to allow more time for a greater number of practices to move into APMs, which have shown an ability to improve quality and lower overall cost of care. 

Failure to renew the incentives could deter participation in a range of primary care payment reform initiatives, including the Primary Care First, state primary care payment reform initiatives like the Maryland Primary Care Program, the Medicare Shared Savings Program, and private sector primary care initiatives. “Ending these important incentive payments would discourage future participation in models that have seen growing uptake in recent years,” the letter states. “The incentive payments...provide additional resources that can be used to expand services beyond traditional fee-for-service.” 

Read the full letter here.

PCC and the Better Health – NOW Campaign support key provisions of the Telemental Health Access Act discussion draft
 
Telehealth technologies have the potential to contribute to safe, high-quality primary care particularly if utilized in coordination with an individual’s medical home. PCC and the Better Health – NOW Campaign support key provisions of the Telemental Health Access Act discussion draft including those described below:

• PCC supports removing the requirement for in-person visit for tele-mental health visits and leaving the decision of the appropriate modality of tele-mental health care to the professionalism and training of the care team and the patient.
• PCC supports provisions enabling primary care practices to rely on audio-only telemental health services beyond the pandemic.
• PCC urges the Committee to work with CMS to limit the burden on practices associated with any modifier.
• PCC supports requiring the Secretary of HHS to issue guidance on provision of Medicare telehealth services for individuals with limited English proficiency.