July Month in Review: Primary Care & Purpose Above Politics

Primary Care & Purpose Above Politics
Thursday, July 28th

Dear Members and Friends, 

As the Republican & Democratic conventions conclude, the discourse about our nations’ future and our highest aspirations have taken center stage. The health of our country is up for election. What do we believe? What do we want? How does our collective work contribute to that vision?

Almost ten years ago, there was ample bipartisan agreement that the U.S. health care system was overpriced and underperforming. Although not on most policymakers’ radar, a small insightful group of leaders joined efforts to elevate the role of primary care as a means to address this crisis. They believed that by making primary care foundational to the U.S. health system, we could provide better value to patients and payers, and better support the clinicians who compassionately care for our families in times of sickness and in health. And thus the Primary Care Collaborative was born: an initial collaboration between health care providers and payers with a belief that we could do better for patients and families.

We pushed for a model of advanced primary care – the patient-centered medical home – that could be spread and scaled. Because our increasingly broad and diverse membership was unified and motivated, the model spread quickly and the evidence to support it grew. We pushed for adoption of the medical home in both the public and private sectors, in states and communities, and ultimately in the Affordable Care Act. Through a proliferation of multi-payer efforts, including the Multi-payer Advanced Primary Care initiative (MAPCP) and the Comprehensive Primary Care initiative (CPC), we are learning how to better support primary care practices to deliver accessible, coordinated, comprehensive, and continuous care. And to ensure adequate and sustainable payment for the medical home, we are pushing for the Medicare Access and CHIP Reauthorization Act (MACRA) to recognize and reward advanced primary care for Medicare beneficiaries.

Is our work done? Is there still a need to unify around advanced primary care? To what end?

We have not resolved the conundrum of an overpriced and under-performing U.S. health system for consumers and patients. Yet just this week Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services, tweeted:

The momentum is with us, and our hard work is beginning to pay off. Ten years after the Collaborative’s creation, primary care is very much on policymakers’ radar, and on both sides of the aisle. And though this is cause for deserved celebration, too many primary care practices – and the communities they serve – are not yet seeing the fruits of our labor, especially in small and solo practices. Clearly defining the value of primary care to payers, providers, and patients remains a work in progress. As November approaches, we must ask ourselves what we want and how our broad and diverse set of stakeholders is uniquely positioned to help us achieve it. 

Please join us in November to chart the path forward.

Marci Nielsen, PhD, MPH
President & Chief Executive Officer

PCPCC Annual Fall Conference & Awards Dinner to Celebrate 10 Great Years of Achievements!

Barbara Starfield Awards Dinner to Honor IBM's Dr. Paul Grundy
This year marks the PCPCC’s 10th anniversary, and we plan to celebrate a decade of accomplishments in a big way! The celebration will kick off Wednesday, Nov. 9, with our exclusive executive member annual meeting, followed by a cocktail reception and an unforgettable 10th Anniversary Barbara Starfield Awards Dinner.

This year, we will honor three distinguished individuals who have dedicated their careers to promoting advanced primary care and the medical home, including the Founding President of the PCPCC, Dr. Paul Grundy, Chief Medical Officer and Global Director of Healthcare Transformation at IBM. We will thank him for his significant accomplishments and wish him well as he retires from the PCPCC Board of Directors. 

Salvatore Volpe, MD, will receive the Patient-Centered Medical Home Practice Award for his outstanding dedication to promoting a coordinated health care system that achieves improved quality and access at lower costs. Dr. Volpe’s unparalleled commitment to improving care is evident in his creation of a patient-focused environment within his medical practice, as well as his relentless work as a physician champion in promoting the use of electronic health records and health information technology for quality improvement.

We will also present Edward Wagner, MD, MPH, with the Primary Care Community/Research Leadership Award, recognizing his outstanding dedication to developing and disseminating health care innovations designed to transform the way care is delivered. Dr. Wagner created the well-known and widely used Chronic Care Model, and over the course of his career has worked to support high-functioning primary care teams to meet the quadruple aim: better care experiences, better population health, lower cost, and happier staff.

Don't miss the opportunity to mix and mingle with many of the most influential leaders in health care transformation. Reserve your seat for the Awards Dinner today!
2016 Annual Fall Conference: Primary Care, Our Primary Cause
After Wednesday’s executive member meeting and Award’s Dinner, our 2016 Annual Fall Conference officially kicks off on Thursday, November 10th. We’ve added new, dynamic content, and condensed into a single full-day event. On Friday, November 11th we will host two special post-conference summits: one on Patient and Family Partner Training, and another to develop the new “Shared Principles of Primary Care” in partnership with Family Medicine for America’s Health. More details to come!

Conference headline topics include (but are not limited to):

Primary Care & Policy: Post-Election AnalysisLiz Fowler, who serves on our Board of Directors, will moderate a discussion with health policy experts from “both sides of the aisle” on the post-election environment for health system and payment reform:

Liz Fowler, PhD, JD, serves as Vice President, Global Health Policy, in the Government Affairs & Policy group at Johnson & Johnson. She previously served as Special Assistant to the President for Healthcare and Economic Policy at the National Economic Council, Deputy Director for Policy of the Center for Consumer Information and Insurance Oversight (OCIIO within HHS), and Chief Health Counsel to Senate Finance Committee Chairman, Senator Max Baucus (D-MT), where she played a critical role in developing the Senate version of health reform and the 2003 Medicare Prescription Drug, Improvement and Modernization Act.

Dan Todd, a former senior aide to Sen. Orrin Hatch (R-Utah), now has his own healthcare consulting firm, Todd Strategy. He joined Hatch’s staff in 2011, and most recently served as his health policy director on the Senate Finance Committee. Todd bills himself as a “key architect of the landmark bipartisan, bicameral legislation to fully repeal and replace the broken Sustainable Growth Rate (SGR) formula.” Prior to his congressional work, Todd served in the policy shops at the biopharmaceutical companies EMD Serono and Amgen.

Yvette Fontenot, MPP, is a Partner at the DC boutique government relations firm, Avenue Solutions. In addition to serving as the Deputy Director of the Office of Health Reform at the Department of Health and Human Services, Yvette previously served as professional staff for the Senate Finance Committee during health reform, the House Committee on Energy and Commerce for Congressman John D. Dingell from Michigan, and as Senior Legislative Advisor for Health Policy for Senator John D. Rockefeller, the Ranking member of the Health Subcommittee of the Senate Finance Committee

Paying for High-Performing Primary Care: A View from Payers -  Jill Hummel, JD, who serves on our Board of Directors, will moderate a discussion with health care payment reform experts regarding new policies that offer greater funding to support advanced primary care:

Jill Hummel, JD, serves as the Chair Elect of the PCPCC Board of Directors and as the President & General Manager at Anthem Blue Cross Blue Shield of Connecticut. Prior to this position she served as the Vice President of Payment Innovation for WellPoint, Inc. where she was accountable for developing provider payment and delivery models that reward and support improvements in health care quality, patient safety, health outcomes, health status and access while reducing the unnecessary cost associated with today’s fragmented health care system. In this role, Ms. Hummel led the expansion of WellPoint’s patient centered, value based, provider arrangements which now cover over 22,500 physicians including 14,500 primary care providers and 52 accountable care organizations and benefit more than 1.75 million members. 

Suzanne F. Delbanco, PhD, is the executive director of Catalyst for Payment Reform. Catalyst for Payment Reform is an independent, non-profit corporation working on behalf of large health care purchasers to catalyze improvements to how we pay for health services and to promote better and higher value care in the U.S. Previously, Suzanne was the founding CEO of The Leapfrog Group. Suzanne holds a Ph.D. in Public Policy from the Goldman School of Public Policy and a M.P.H. from the School of Public Health at the University of California, Berkeley.   

Laura Sessums, JD, MD, serves as Director of the Division of Advanced Primary Care at the U.S. Center for Medicare & Medicaid Innovation. At CMMI, she works on the Comprehensive Primary Care initiative and is actively engaged in thinking about new models for care delivery and payment in primary care. Previously, she worked in academic medicine as a clinician-educator, mostly at Walter Reed Army Medical Center (as a civilian), where she served as the Chief of the General Medicine Section. Her professional activities have been in the areas of health care policy and advocacy, medical education, senior medical administrative leadership, and scholarship at the intersection of law and medicine. Her research has focused on primary care, particularly ethical and legal domains. She is a general internist and former lawyer and remains an Associate Professor of Medicine at the Uniformed Services University of the Health Sciences.

Explore the full conference agenda and don't miss this once-a-year opportunity to learn from the best and brightest in health care transformation and advanced primary care!
Showcase Your Support for Primary Care & the PCPCC:
Invest in a Sponsorship
Sponsorship of our Annual Fall Conference and/or Barbara Starfield Awards Dinner provides the perfect opportunity to not only show your company or organization's support for patient-centered primary care, but also to make valuable contacts and develop relationships with the top players in advanced primary care, medical home, and accountable care markets. Various levels of sponsorship opportunities are available, and PCPCC executive members receive discounts on sponsorships.

Thanks to the generous sponsors that have already committed to support this year's conference. Please join them in supporting our mission:  


This Month's Must Reads
Primary Care Doctors Can Get Paid for Modernizing In New CMS Program
Bloomberg BNA Health Care Blog | 7/26/2016

Summary of Major Provisions in the Proposed 2017 Physician Fee Schedule
Lexology | 7/22/2016

Here Are the MACRA Questions Every Healthcare Provider Must Ask
Healthcare Finance | 07/18/16

Proposed Physician Fee Schedule Emphasizes Primary Care
HealthLeaders Media | 7/11/2016

The Critical Role of Clerks in the Patient-Centered Medical Home
Annals of Family Medicine | July/August 2016

View additional news articles and studies on our website at pcpcc.org/news.
July National Briefing Webinar

 The MACRA Impact: Anticipated Challenges of Solo and Small Practices

Word on the street is that the Medicare Access and CHIP Reauthorization Act (MACRA) may present challenges for solo and small practices. Will it lead to unintended negative consequences for this important segment of the health care system? View our July National Briefing Webinar to get the inside scoop. 

Travis Broome, MPH, MBA, executive director
and policy lead at Aledade, Inc., shares expert insight regarding what small practices can do to both prepare for and overcome possible challenges so that they can succeed under MACRA. 

Proposed 2017 Medicare Physician Fee Schedule Includes Increased Payment for Primary Care
This month, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Physician Fee Schedule to transform how Medicare pays for primary care through a new focus on care management and behavioral health designed to recognize the importance of the primary care work providers perform. The rule also proposes policies to expand the Diabetes Prevention Program within Medicare starting January 1, 2018. This is the first time a preventive service model from the CMS Innovation Center would be expanded into the Medicare program.

These changes will improve payment for clinicians who are making investments of time and resources to provide more coordinated and patient-centered care. These proposed coding and payment changes will better reflect the resources involved in furnishing contemporary primary care, care coordination and planning, mental health care, and care for cognitive impairment, such as Alzheimer’s disease. In addition, these proposed changes further reinforce Medicare’s transformation to better align priorities and reward physicians for quality care through the Quality Payment Program. Read more here.

Upcoming Events
July 28 - August 31

For additional events, click here.
Practice Transformation Through Patient Partnerships

"Patients and their families are an abundant source of wisdom as we navigate the stormy seas of health care delivery. To go at it alone without their partnership is foolish and unwise. With patients as equal partners in the journey of health care transformation, our work together is more fulfilling, more meaningful, and more likely to help them reach their health goals."

Dr. Joseph Bianco, MD, FAAFP, Director of Primary Care, Essentia Health

PCPCC SAN Offers Training to Patient and Family Partners 

Earlier this week, the PCPCC attended IPFCC's 7th International Conference on Patient- and Family-Centered Care in New York City, where we provided trainings on peer support and clinical transformation to participating patient and family advisors.   

We also had the opportunity to network with patient-centered healthcare professionals from all over the world, hear inspiring stories of patient-practice partnerships, and learn strategies to successfully implement and advance person-centered care.  

Special thanks to our colleagues at Peers for Progress, The Hali Project, and PeaceHealth for partnering with us and sharing their expertise at this empowering event.
Visit our SAN website for additional resources on patient-practice partnerships.

On the Road With the PCPCC President & CEO
PCPCC President & CEO Marci Nielsen, PhD, MPH, will serve as the keynote speaker on August 19th at the Annual East Hawaii Independent Physicians Association Symposium where she will present on the topic, “What Can Employers Do to Support Patient-Centered Care?"

September 8th she will attend a special invitation-only meeting in Washington, DC, sponsored by the U.S. Agency for Healthcare Research and Quality: "Advancing the Science and Implementation of Patient Narrative Elicitation and Reporting." This meeting will focus on new methods for both collecting and reporting patient narratives about individual physicians and their office staff.

In mid-September, Marci will travel to New York City to present the keynote address at the NYU Interprofessional Education Symposium on Oral Health, "Transforming Whole Person Care Through Medical-Dental Collaboration." Her presentation will address the necessary vision for an interprofessional, whole-person health future linking oral health, primary care, and overall health. 

Follow Marci on Twitter @Marci_PCPCC to stay in touch!

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