In response to the release of participation data for Medicare’s Accountable Care Programs, Primary Care Collaborative President and CEO Ann Greiner Issued the following statement:

“The launch of the ACO Primary Care Flex program on January 1 is an important step forward – helping Medicare primary care teams move from a fractured, unpredictable payment system toward one that provides much needed stability.

“We particularly congratulate the nearly 19,000 clinicians and the more than 1000 clinics, health centers and critical access hospitals for taking action to strengthen care teams and deliver better care for their patients.

“This exciting new program—which PCC and its members urged the CMS Innovation Center to launch—will provide insights into the effectiveness of hybrid payment structures within the Medicare Shared Savings Program.

“We urge Congress and the Administration to assure broad availability of hybrid payment alternatives – a mix of prospective and fee-for-service payment — that invest more in primary care and equips practices to better meet America’s chronic disease challenges.”

Additional Background

Strong evidence demonstrates that primary care is central to a healthier America and lowers costs. Both Congressional Budget Office (CBO) analysis and real-world results consistently show primary care-centric organizations outperform others at achieving better health outcomes and generating savings.

For additional evidence, please see the following resources:

• PCC’s 2024 Evidence Report, released November 20, which shows both that primary care delivers greater savings AND identifies ‘bright spot’ innovators producing superior results in varied American communities.
• Data from 26 employers showing how they leveraged advanced primary care to achieve 30% savings;
• A case study leading Medicare Advantage plan that has demonstrated the success of senior-focused primary care nationwide;
• An independent private sector analysis which has found similar savings among Medicare Shared Savings Program ACOs, a finding later substantiated by the Center on Medicare and Medicaid Services’ (CMS) own data; and
• The above mentioned April 2024 CBO report which found savings in primary-care centric ACOs to be twice as high as those aligned with hospitals.

Washington, D.C. (November 20, 2024) – Primary care centric ACOs provide better quality outcomes and generate more than twice the savings of their peers, according to a new report released by the Primary Care Collaborative (PCC).

Primary Care: The MVP of MSSP — written in partnership with the Robert Graham Center and Simple Healthcare — examined more than six years of data in the Medicare Shared Savings Program (MSSP).

“This report reinforces research demonstrating that access to primary care in total cost of care models curbs costs and boosts quality of care,” said PCC President and CEO Ann Greiner, one of the authors of the report. “If Congress is serious about improving Medicare, it’s critical they include strengthening primary care at the heart of those efforts.”

The analysis found that ACOs with more than 50 percent of physicians engaged in primary care consistently outperformed those with less than a majority of primary care physicians. Primary care centric ACOs were more likely to lower costs and earn back savings through MSSP, generating 2.4 times as many savings other ACOs over a six-year period

The MSSP was established by the Affordable Care Act in 2012. The program is a voluntary, value-based model in which ACOs receive a portion of the savings they generate, provided they reach cost and quality benchmarks The MSSP has generated savings for seven consecutive years, reaching $2.1 billion in 2023 — the largest in the program’s history.

“This research shows the central role that primary care has played in generating record savings in MSSP,” said Mark Del Monte, CEO and Executive Vice President of the American Academy of Pediatrics and Chair of PCC’s Board of Directors. “If policymakers want to continue building on the successes of the MSSP program, stronger investments in primary care through value-based models would be an important place to start.”

The report also lists 25 “Bright Spots” (high-performing MSSP ACOs) and provides further insight in three case studies — the Colorado-based Community Health Provider Alliance, the Louisiana-based MSSP Enhanced ACO and One Health Nebraska — and explored key learnings. Notably, these high-performing ACOs:

• Provide timely, actionable data to practices and community health centers (CHCs) to inform clinical decision-making
• Establish learning communities or labs to share best practices to increase alignment between practices and CHCs
• Empower practices and CHCs to work independently to achieve results that benefit ACO patients and members
• Focus on simple, proactive health care interventions and clearly define outcomes and financial goals
• Support practices and CHCs in developing creative, localized strategies to transform care

Read the full report here. 

In response to the release of the final CMS Part B and Fee Schedule rule, Primary Care Collaborative President and CEO Ann Greiner issued the following statement:

“While today’s rule contains harmful, statutorily mandated pay cuts — cuts that Congress can and must address this year — the Primary Care Collaborative (PCC) is pleased that CMS has acknowledged the importance of primary care by finalizing new Advance Primary Care Management services. The Agency has taken an important first step down a path toward permanent payment reform, and we look forward to working with CMS to refine and improve the new services.

“At a time when more and more Americans are struggling to find primary care, both CMS and Congress must build on today’s rule and evolve still bolder payment solutions.  By doing so, policymakers can help stem the erosion of the primary care workforce and give clinicians the flexibility they need to spend more time with patients.”

PCC’s Better Health – NOW Campaign has called on the Administration and Congress alike to remove barriers to reform — cost-sharing, lack of behavioral health integration, outdated budget neutrality requirements and the persistent, systematic undervaluation of primary care — and stand up well-designed hybrid payment options broadly available across Medicare and other payers.

See PCC’s Letter to Senate Finance Committee Chairman Ron Wyden and Ranking Member Mike Crapo here.

 See PCC’s Comments on CMS’s Proposed rule here.

Primary Care Collaborative President and CEO Ann Greiner has issued the following statement in response to the Centers for Medicare and Medicaid Services announcement that the Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion in net savings in 2023 — the largest savings in the Shared Savings Program’s history:

“The PCC applauds the 2023 historic performance results that MSSP ACOs have achieved in more robust quality improvement for beneficiaries, higher cost-savings for the program, and greater shared savings for high-quality ACOs.”

“As we’ve seen over the past six years, primary care has played an outsized role in driving high performance,” continued Greiner. “And if policymakers want to continue to achieve these successes in Medicare, we need better support for primary care in MSSP and beyond.”

“And, we are encouraged to see the Administration taking such steps by introducing an innovative new approach to payment in the ACO Primary Care Flex Model, with a January start date. We hope that it is one of many efforts payers implement to invest more in primary care.”

Washington, D.C. (October 7, 2024) – Adults in the United States overwhelmingly prefer receiving care from primary care practices (73%) over retail clinics (5%), urgent/walk-in care clinics (12%) and emergency departments (4%)—but many encounter difficulty accessing and affording primary care, according to a public opinion survey released by the Primary Care Collaborative (PCC).

Nearly three-quarters (73%) of U.S. adults prefer to receive primary health care services at a primary care practice, with 90% of Americans 55 and older preferring primary care practices over alternatives.

But, while demand for primary care is high, Americans are increasingly facing challenges accessing the primary care they prefer.

Just over one-in-four (28%) adults indicated they did not have an ongoing relationship with a primary care clinician. Of those who do, nearly one-in-four (23%) indicated they were either only sometimes able (17%) or were never able (6%) to get an appointment with their care team in the past six months.

“The data confirms what patients and clinicians already know: The public wants high-quality primary care from a team that knows their health needs,” said Ann Greiner, president and CEO of the PCC. “Too many people cannot access the front door of our health care system due to decades of underinvestment. Policymakers need to better support primary care so that it is available for everyone in all communities.”

The data underscores recent research from the PCC indicating that the number of primary care clinicians is dwindling due to underinvestment, leaving more people unable to establish a regular primary care relationship. The United States spends less than five cents of every health care dollar on primary care, despite evidence that it improves outcomes for patients at lower costs. Having access to a regular source of primary care is associated with fewer emergency department visits and hospitalizations, lower odds of dying prematurely and lower health care costs.

In addition to facing challenges getting an appointment, most Americans also cited costs and lack of appointment availability as obstacles to getting primary care. About half (51%) said out-of-pocket costs such as copays or deductibles are at least sometimes a major barrier to getting needed primary care.

“A financial barrier to people getting preventative and chronic care services is penny-wise and pound foolish,” said Greiner. “Employers and government end up footing more expensive bills down the line and patients suffer.”

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1,164 adults. Fieldwork was undertaken between 30th August – 2nd September 2024. The survey was carried out online. The figures have been weighted and are representative of all U.S. adults (aged 18+).

Media Contact: Tod Didier
tdidier@thepcc.org | 202-417-2069

Washington, D.C. (March 28, 2024) – The Primary Care Collaborative (PCC) applauds the Centers for Medicare and Medicaid Services (CMS) for its efforts to support continuity of care — particularly primary care — by streamlining enrollment and eligibility in federal health programs.

“No child, senior or disabled person should have to worry about red tape when they need care,” said PCC President and CEO Ann Greiner. “We’re grateful that CMS is taking steps to address coverage disruptions and cost barriers that erode Medicaid and CHIP enrollees’ access to care overall, and to primary care, the front door of our health care system.”

In policy priorities released this January, PCC and its Better Health – NOW Campaign partners called on CMS to work with states to pursue continuity of coverage protections and assure beneficiaries are connected to a regular source of primary care.

The PCC looks forward to reviewing the details of the final rule with its members and will continue working with the Administration to ensure Americans have access to the coverage and care they need to manage their health effectively. The PCC also urges Congress to work on a bipartisan basis to expand continuity of Medicaid coverage – starting with children and dually eligible beneficiaries.

About the Primary Care Collaborative

Founded in 2007, PCC is a multistakeholder organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care. Representing a broad coalition that includes patient and consumer advocacy groups, health care clinics, professional societies, payers, leading corporations and other health care stakeholders, the PCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support the growth of high-performing primary care to achieve the “Quintuple Aim”: better care, better health, lower costs, greater joy for clinicians and staff, and greater health equity.

FOR IMMEDIATE RELEASE
Media Contact: Tod Didier
tdidier@thepcc.org | 202-417-2069

Washington, D.C. (May 15, 2024) – Ann Greiner, President and CEO of the Primary Care Collaborative, issued the following statement regarding the introduction of the Pay PCPs Act of 2024 by Senator Sheldon Whitehouse (D-RI) and Senator Bill Cassidy (R-LA):

“We’re heartened to see Senator Whitehouse and Senator Cassidy’s bipartisan commitment to improving seniors’ access to comprehensive primary care by proposing legislation that would offer hybrid payment (a mix of FFS and prospective payment) to Medicare primary care practices.

With our Better Health-NOW Campaign partners, we’ll respond to the Request for Information and look forward to working with Senator Whitehouse, Senator Cassidy and their peers to secure bold reforms that strengthen primary care.”

As demonstrated by CBO reports and the best research, well-designed primary care payment reforms can unlock powerful improvements in health outcomes and a more affordable health care system.

About the Primary Care Collaborative

Founded in 2006, the Primary Care Collaborative (PCC) is the leading national, nonpartisan and multi-stakeholder voice advocating for better health for all Americans by strengthening primary care. The PCC unifies and engages diverse stakeholders in promoting policies and sharing best practices that encourage the growth of high-quality, comprehensive primary care.

FOR IMMEDIATE RELEASE
Media Contact: Tod Didier
tdidier@thepcc.org | 202-417-2069

Washington, D.C. (May 20, 2024) – The Primary Care Collaborative (PCC) thanks Senator Wyden and Senator Crapo for highlighting options to strengthen primary care for seniors and people with disabilities in their white paper, Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options for Medicare Part B.

PCC was encouraged to see lawmakers considering a hybrid payment model for primary care under traditional Medicare – an important change to expand access to high-quality, comprehensive primary care, improve health outcomes and generate cost-savings for Medicare.

“Every day it becomes harder and harder for people to find a primary care clinician and team they trust,” said Ann Greiner, President and CEO of the Primary Care Collaborative. “Introducing hybrid models will help bolster the primary care workforce and expand seniors’ access to high-quality, comprehensive primary care.”

Friday’s white paper adds to the momentum behind the hybrid primary care payment proposals, sought by the PCC, its Better Health — NOW partners and Senators Whitehouse and Cassidy, who recently introduced the Pay PCPs Act (S. 4338). That legislation would ensure all Medicare primary care practices have access to hybrid payment models – giving them the flexibility they need to deliver better care to patients.

“The evidence is crystal clear: giving primary care viable alternatives to fee-for-service leads to better health and greater cost savings for Medicare,” said Greiner.

As noted by the Finance Committee’s white paper:

• Independent evaluations found that earlier primary care models kept Medicare beneficiaries out of the ED and away from unnecessary hospitalizations – with the best results from independent and ACO-associated practices.
• CBO’s latest report found primary care-centric ACOs achieve twice the savings of others.
• ACOs with hybrid payments—including participants in the soon to be launched (Jan 25) ACO Primary Care Flex model announced by the CMS Innovation Center—can be an important pathway for shifting primary care away from per-visit volume and towards a more predictable and greater investment in primary care.

PCC looks forward to working with Chairman Wyden, Ranking Member Crapo and all the members of the Finance Committee to advance their goals this year.

About the Primary Care Collaborative

Founded in 2006, the Primary Care Collaborative (PCC) is the leading national, nonpartisan and multi-stakeholder voice advocating for better health for all Americans by strengthening primary care. The PCC unifies and engages diverse stakeholders in promoting policies and sharing best practices that encourage the growth of high-quality, comprehensive primary care.

FOR IMMEDIATE RELEASE
Media Contact: Tod Didier
tdidier@thepcc.org | 202-417-2069

The Primary Care Collaborative’s President and CEO Ann Greiner issued the following statement in response to the announcement that Wal-Mart will be closing all in-store primary care clinics:

“Wal-Mart’s recent announcement only confirms what every primary care clinician across the country already knows: we have a system that doesn’t support the ongoing trusted primary care relationships that deliver better outcomes, create better patient experiences and enhance affordability.

“Until policymakers can shift to a system that allows clinicians to focus on keeping people healthy instead of hunting down payment codes for every service, more and more Americans will struggle to find a usual source of care they trust.

“Policymakers must make fundamental changes to how our health care system values care, starting with the underlying flaws in how and how much Medicare pays for primary care – flaws duplicated across payers in both the private and public sector.”

Recent research conducted by the nonpartisan Congressional Budget Office confirmed what years of evidence has shown: when properly structured and supported, primary care leads to lower costs and better care.

About the Primary Care Collaborative

The Primary Care Collaborative (PCC) is the leading national, non-partisan and multi-stakeholder voice advocating for better health and wellbeing for all Americans by strengthening primary care. The PCC unifies and engages diverse stakeholders in promoting payment/delivery policies and sharing best practices that encourage the growth of team-based, whole-person primary care.

Washington, D.C. (March 19, 2024) – The Primary Care Collaborative (PCC) applauds the Centers for Medicare and Medicaid Services (CMS) and the CMS Innovation Center for taking substantive steps to strengthen primary care to deliver better outcomes by announcing a hybrid payment model under the Medicare Shared Savings Program (MSSP).

The announcement comes less than a year after PCC’s Better Health – NOW mobilized more than two dozen stakeholder organizations in support of CMS and the Innovation Center implementing hybrid payment models (mix of prospective and fee for service) to encourage primary care participation in MSSP and develop primary care led accountable care organizations. NASEM’s 2021 report underscored the evidence related to hybrid payment.

“Primary care is the foundation of an equitable, effective health care system,” said Ann Greiner, President and CEO of the PCC. “Today, CMS and the CMS Innovation Center demonstrated they understand the urgent need to reinforce that foundation.

“We’re also encouraged to see that this model centers equity by promoting participation by rural health clinics and federally qualified health centers, puts guard rails in place to ensure payments reach primary care practices and benefits beneficiaries by giving clinicians a prospective payment that allows them to deliver more flexible, comprehensive care. We’re eager to learn more about this model and its potential to lower costs and improve beneficiary outcomes.”

Dr. Liz Fowler, Director of CMS Innovation Center, will provide additional details about the new model in a presentation and Q&A with PCC President and CEO Ann Greiner during a PCC webinar earlier today. The webinar also featured thoughts and reactions from leaders at the National Association of Community Health Centers, the American Academy of Family Physicians, the National Association of Accountable Care Organizations and the National Partnership for Women and Families.

About the Primary Care Collaborative

Founded in 2006, PCC is a multistakeholder organization dedicated to advancing an effective and efficient health system built on a strong foundation of primary care. Representing a broad coalition that includes patient and consumer advocacy groups, health care clinics, professional societies, payers, leading corporations and other health care stakeholders, the PCC’s mission is to unify and engage diverse stakeholders in promoting policies and sharing best practices that support the growth of high-performing primary care to achieve the “Quintuple Aim”: better care, better health, lower costs, greater joy for clinicians and staff, and greater health equity.