As cities and states start to open up, we are faced with considerable uncertainty – not knowing exactly how COVID-19 spreads, how much risk we’re taking by resuming our normal lives, and whether we will face a second wave.
What is for certain is that primary care is in crisis. We know this via reports from our members, the news we read, and from the regular surveys conducted in partnership with the Larry A. Green Center and 3rd Conversation. Primary care clinicians and patients are facing challenges related to finances, testing and PPE, new technology platforms, mental health issues and more.
Something else we have learned with certainty – and definitely too late in terms of the disease's trajectory – is that people of color are suffering disproportionately in the number of cases and deaths from COVID-19. Before this pandemic, there were persistent health disparities along racial/ethnic lines, which the virus has exploited.
Justified anger at these health disparities have likely contributed to the frustration many feel across the U.S. with our current policies. The brutal death of yet another Black man, George Floyd, at the hands of the police brought home that racial inequities in policing, in health, in education, and in economic opportunity have serious consequences for the Black, Brown and Indigenous men, women and children among us. Protests across the country have brought together people of diverse backgrounds to make it clear to policymakers that things must change.
Primary care is part of the solution and has long been recognized as a key lever to addressing health disparities, with equity called out as a major attribute of high performing primary care by Barbara Starfield. And equity is embeded in the PCC’s Shared Principles of Primary Care, introduced at the end of 2017 and which more than 350 organizations support.
With our statement, the PCC has added our voice to the national conversation about better addressing racism and furthering equity.
As we contemplate how to move forward, it is important for primary care to remember that people need us because they wish to be healthy and whole. Our potential and productivity as human beings is dependent on our all-around health – physical, mental, emotional and more. However, there are so many barriers that stand in the way of health and wholeness, and it’s way past time that we as a community identify and work to remove those barriers, particularly those that are racially oriented.
Our work continues, and we hope that you stand with us at this important juncture in our nation’s history, when it seems possible to accelerate change and make improvements – for primary care, for our patients and for the communities that we serve.
Kind regards,
Update on PCC's Recent Work
COVID-19 has shaped all aspects of PCC’s work over the last four months, given its outsized effect on primary care. Below is a summary of our efforts.
Primary Care & COVID-19 Surveys
In mid-March, PCC formed a strategic partnership with the Larry A. Green Center to keep abreast of how the pandemic is affecting primary care in order to inform PCC’s policy and programmatic work. PCC’s role vis-a-vis the Green Center is to help inform its survey questions, shape the policy implications included in its weekly executive summary of survey results, and help in dissemination to the news media and policymakers.
The survey has helped tell the story of the crisis in primary care and give a real-time voice to the ingenuity, leadership, and dedication of primary care clinicians under extraordinary circumstances. We thank all PCC Executive Members that accepted our invitation to participate in the survey by sending a link to their members.
In May, the Green Center added patient surveys to the mix, and 3rd Conversation joined this partnership. The integration of the results from both surveys help us to better understand the impact of COVID-19 on primary care from two important vantage points.
PCC shares the surveys’ results each week on its website, where we provide many other COVID-19 related updates and resources.
Brief Summary of Survey Results
Since mid-March, the clinician survey has tracked on a weekly basis the ability of practices to provide care during the pandemic. The level of strain has remained high (level 4 or 5 out of 5) for a majority of clinicians – usually for at least 60% – with an alarming trend emerging in mid-May of high numbers (84%) of clinicians reporting severe or close to severe stress and 28% saying burnout is at an all-time high. Practices have experienced low patient volume and inconsistent reimbursement, which hampers cash flow and results in furloughs and layoffs, all creating a downward spiral that is forcing some practices to close. Other aspects of practices that the survey examined include shortages of PPE and testing, which have consistently been problematic.
A key finding from the patient survey is that patients greatly value having a relationship with their doctor during this challenging time, and that a large majority would feel distressed if their practice closed as a result of the pandemic. Majorities of patients have reported being in contact with their primary care practice in the previous 8 weeks, more so than during all of 2019. More specifically, a majority of contact (58%) was by phone, with other modalities – video, secure messaging and patient portals, and in-person – at roughly 20% each. Subsequent surveys show patients continuing to make good use of telehealth connections with their doctors, NPs, PAs and other primary care clinicians.
An important finding in the patient surveys came shortly after the death of George Floyd, when protests were intensifying across the country. The results from the June 8 survey showed that nearly 9 in 10 patients felt racism in the U.S. has an impact on health, with 57% identifying racism as a public health concern.
Advocating for Policy Changes
The survey findings have informed PCC’s policy positions and ongoing discussions with key leaders. Specific actions and details are included in the Policy & Advocacy Update. At the highest level, PCC has been advocating for immediate relief to primary care clinicians to keep their practices open in order to serve multiple, critical roles. These include testing, contact tracing and administering vaccines (along with public health) as well as provision of wellness visits, chronic care management, mental health and other services – all with the goal of helping Americans go back to work and school safely.
Over the longer term, the PCC is working with public and private sector leaders to move primary care to a prospective payment system. This will be more pandemic-proof than fee-for-service, face-to-face visit payment and allow primary care teams to provide a comprehensive set of services to improve patient outcomes and reduce costs.
PCC Educational Programming on COVID-19
Since April, PCC’s webinars have had a COVID-19 focus, and we will continue this series through at least July. (Watch past webinars.) And PCC’s annual conference, now scheduled for November 30-December 1 as a virtual conference (see full article with this announcement), will include a heavy focus on how COVID-19 has shaped primary care and provided opportunities to reimagine primary care. The conference will also address the urgent issue of race and health inequities and how primary care can help to close these persistent disparities.
Oral Health & Primary Care Integration Initiative
PCC’s Advisory Group on Oral Health and Primary Care Integration, a new initiative supported by the DentaQuest Partnership for Oral Health Advancement, has been meeting to discuss innovations in this space, the effects of the pandemic, and related policies. The group, made up of 14 thought leaders from diverse sectors including oral health, primary care, patients, academia, employers, health plans, and policymakers, has begun to outline a compendium of exemplary case studies that highlight successful models for integration of oral health and primary care and identify related themes. The final product will be released toward the end of the year. The innovations featured in the compendium will be organized by the seven by the Shared Principles of Primary Care, particularly the third principle, which inspires clinicians to strive toward care that is more “equitable.”
Building on work that the PCC did on shared decision-making (SDM) previously, we will be examining existing literature on SDM in behavioral health and convening experts to consider how exemplar tools may be further integrated into behavioral health and primary care practices. The project will also leverage PCC’s existing behavioral health integration workgroup for guidance and planning of the roundtable of experts. Intended objectives of the project include:
exploring enablers and barriers to shared decision-making, specifically in behavioral health, to create recommendations on how to increase its use
informing future research agendas of PCORI and other research institutions
producing a webinar and related communications that can be disseminated to the broader behavioral health and primary care communities to increase knowledge and uptake of evidence-based shared decision-making best practices.
Policy & Advocacy Update
The PCC has been dedicated to documenting the plight of primary care practices and patients during the historic COVID-19 pandemic as well as leading multi-stakeholder strategies and advocacy to save and strengthen primary care right now.
We have amplified and lifted up key messages of the #SavePrimaryCare campaign, including disseminating our letter to Department of Health and Human Services Secretary Alex Azar widely and leveraging our social media presence. Feel free to use our letter to write your own letter to urge Azar to make a targeted allocation from the CARES Act provider relief fund for primary care practices.
We redoubled our outreach to congressional offices and HHS officials to highlight the staggering $15 billion figure - the recent estimate from researchers at Harvard Medical School’s Center for Primary Care of revenue losses that primary care practices will collectively sustain in 2020. The PCC is grateful for the work of Sanjay Basu, MD, PhD, and colleagues and the willingness of Health Affairs to fast-track release of this careful, conservative estimate of financial losses by primary care practices sustained collectively and at the practice level. Most alarming, the study estimates losses could grow to $19 billion if the predicted second-infection wave comes in the fall, and losses could reach $39 billion if HHS retreats from the temporary emergency-based telehealth payment policies.
Together with our leadership, the PCC is beginning to compile and prioritize which of the many regulatory waivers we would like to see become permanent to accelerate primary care transformation and payment-reform efforts. We signed on to a letter led by HIMSS to signal our interest in making some of the Medicare telehealth waivers permanent.
Temporary Federal Waivers of Payment, Other Rules
While the federal response to COVID-19 has been mixed at best, HHS leadership has taken extraordinary steps to waive regulations in order to give flexibility to the healthcare delivery system to more readily serve patients safely with virtual visits. With authorization from Congress, restrictive Medicare telehealth rules have been lifted, payment parity established, and telephonic visits made eligible for reimbursement. For more information about these changes and their contingency on different federal emergency declarations, see McDermott Consulting’s helpful summary.
Waivers Support Team-Based Care, Virtual Care
The broad sweep of regulatory waivers by federal and state authorities during the pandemic cannot be understated. The Alliance for Connect Care has been tracking them. The regulatory waivers encompass supervision requirements, whether a relationship has been “established” before treating a patient via telehealth, which clinicians are eligible to provide treatment and bill for telehealth services, how methadone is dispensed to patients in treatment for opioid addiction, and whether a licensed physician can treat a patient residing or staying across state lines. These are just a few of the regulations that have been waived by federal and state officials. Many of these regulations inhibit the development of team-based care and the ability of practices to innovate and optimize the team’s effectiveness and efficiency. Some are not patient-centered and rather paternalistic.
The PCC looks forward to hearing from our membership about how to leverage the possibilities created by these waivers if they were to be made permanent, while also including guardrails that ensure accountability for quality, appropriateness of care and patient privacy.
Highlights from the States: Efforts to Increase Primary Care Investment Continue
Below are brief summaries of the efforts of five states to support primary care, including efforts that COVID-19 has prompted given the financial challenges that the pandemic has wrought.
North Carolina
As this newsletter is disseminated, PPC applauds Blue Cross and Blue Shield of North Carolina’s recent announcement to support independent primary care practices financially as they weather the COVID-19 storm. Financial support will be in the form of per BCBSNC beneficiary payments estimated to make the 2020 practice revenue equivalent to 2019 revenue. To be eligible, practices must commit to remaining independent and joining one of BCBSNC’s value-base primary care or ACO payment models by 2021, which means joining its Blue Premier network payment model. For more information, see Chief Medical Officer Rahul Rajkumar’s post.
Massachusetts
In late 2019, Massachusetts Gov. Charlie Baker released comprehensive legislation that would incentivize health plans and providers to devote more resources to primary care and behavioral health services. It builds on Massachusetts’ comprehensive approach to managing growth in the total cost of care and its cost benchmarking process (see below). While the bill has not advanced in 2020, it remains a post-COVID-19 priority for the governor. See the summary.
Delaware
In June 2020, Delaware issued a “preliminary look” at aggregate state healthcare spending under its state healthcare spending benchmark, which was established by executive order of Governor John Carney in 2018. The report, which uses data submitted by insurers, includes an attempt to measure primary care spending and will provide an opportunity for primary care advocates to dig deeper into the numbers and continue to educate stakeholders.
California
There were a number of recent efforts to support and further primary care, including those driven by employers, a health plan and nurse practitioners.
The Pacific Business Group on Health teamed up with the California Medical Association on a proposal called the Care for Californians Initiative that would require health plans to use unspent premiums already collected from employers and consumers to pay primary care providers emergency prospective payments in 2020 and 2021.
Blue Shield of California announced an ambitious Health Reimagined initiative that will use value-based payment models and take a “holistic” approach to care while leveraging digital tools and efforts to reduce administrative burdens on physicians.
Legislation was introduced early in 2019 to give nurse practitioners expanded scope to practice independently. It passed out of the state assembly before stalling in the state senate but remains a priority for advocates of care for underserved communities, such as the California Health Care Foundation.
Maryland
The Milbank Memorial Fund sponsored an issue brief from the team leading Maryland’s Primary Care Program (MDPCP). A multi-payer model that is integrated with Maryland’s broader all-payer “total cost of care model,” the MDPCP is a comprehensive approach that builds on learnings from the CMMI Comprehensive Primary Care (CPC) and CPC+ models. Maryland’s investments in health information exchange and data collection will also support MDPCP.
If we missed your state and an item you want to share, please reach out to Alyssa Neumann at ankane@pcpcc.org
The COVID-19 pandemic has upended everyone’s plans for regular events and gatherings, and so PCC’s annual conference, originally scheduled for November 5-6, 2020, is being totally reconfigured and rescheduled into a different kind of event. Here are the details:
Title: Crisis as Catalyst: Reimagining Primary Care
Format: Virtual event – all parts of the conference (keynote addresses, panel and breakout sessions, times for networking, etc.) will happen online
Dates: November 30 to December 1, 2020 | late morning and afternoon hours (Eastern time) both days
Who can attend: Both PCC members and non-members are welcome
Registration and fees: Registration will open later this summer.
Program/topics: The program will be heavily shaped by the major events of 2020 – the coronavirus pandemic, demonstrations and national conversations about racism and equity, and the November general election. All of these events have had an impact on primary care and have resulted in both positive and not-so-positive changes. The conference will consider these questions and more:
What do these changes mean for primary care in the present and future?
How can we use these times to make permanent reforms to primary care payment and care delivery and rebuild it into something even better?
What does equity in health care look like, and how can primary care play a leading role in addressing disparities?
What is primary care’s role relative to public health and how does primary care better connect to the community and provide a more comprehensive set of services?
How can we continue to make a strong foundation of primary care as key to the nation’s health?
Conference planners are building an impressive lineup of speakers who have been addressing these questions and playing a leading role in primary care during these transformative times. Speakers will include leaders, thinkers and experts in policy, health plans, primary care practices, patient care and other areas.
More details on the virtual annual conference will be released as they become available. Watch for details in PCC’s newsletters, emails, main and conference websites and social media channels.
Primary Care Investment 2.0—State Innovation workshop for PCC Executive Members and State Leaders
Rescheduled to December 2, 2020 (immediately following the annual conference)
Like the annual conference, this event will also be held online. This session will build on PCC’s first primary care investment workshop hosted in fall 2018. This year’s convening will bring together PCC Executive Members along with state leaders, policymakers and advocates to highlight lessons learned, engage with each other, tackle emerging issues, and discuss shared agendas for advancing investment in primary care. PCC will also release its 2020 Evidence Report at this event.
More details will be shared soon.
Call for Nominations for PCC's Annual Awards
We are seeking nominations for primary care leaders who have shaped the primary care field. These champions will be recognized with the:
Barbara Starfield Primary Care Leadership Award
Primary Care Community Leadership/Research Award
Advanced Primary Care Practice Award
The honorees will be announced during PCC's Virtual Annual Conference on November 30-December 1, 2020.
In the wake of police brutality and pervasive racial injustice, which has spurred numerous, ongoing demonstrations across the country, the Primary Care Collaborative (PCC) reaffirms its commitment to racial equality.
PCC underscores this commitment in the midst of the COVID-19 pandemic, in which Black and Brown people have suffered disproportionately in the number of cases and deaths. Furthermore, PCC recognizes that structural racism contributes to inequities in health care and that our country’s healthcare system itself, like many other systems, perpetuates discrimination and inequality and must be reformed.
PCC, as an organization whose mission is to convene and unite a broad group of public and private organizations to strengthen primary care, is well-positioned to help address racial inequalities in health care. PCC’s commitment to doing so is reflected in its vision for primary care, embodied in the seven Shared Principles of Primary Care.
Working with the primary care community, the PCC and FMAHealth spearheaded the development of these principles, which were introduced in October 2017. To date, more than 350 organizations representing diverse healthcare stakeholders have adopted them. They are a vision to move the United States toward a vibrant future of person-centered, team-based, and community-aligned primary care. PCC affirms the goals of these principles - that individuals are valued, have agency, and deserve health and wholeness in all aspects of their lives - physical, emotional, psychological and spiritual, as well as according to their cultural, linguistic and social needs.
The third of the seven Shared Principles is “comprehensive and equitable” and inspires primary care clinicians to “seek out the impact of social determinants of health and societal inequities” and to “partner with health and community-based organizations to promote population health and health equity, including making inequities visible and identifying avenues for solutions.”
Recent events have convinced us that we need to redouble our efforts in this area. We will continue to stand for equality across racial and ethnic lines and work toward ensuring that people who have been unrecognized and underserved receive the kind of health care and support for their health that they deserve. We stand with our allies across the community to advance this vision of racial justice and health equity.
- Statement issued June 24, 2020
Project Update
PCC to begin new PCORI project
In May, PCC was given a Eugene Washington PCORI Engagement Award for Community Convening Around Patient-Centered Outcomes Research (PCOR). With this funding, PCC will execute a project titled “Increasing Uptake of Behavioral Health Shared Decision-Making Tools."
PCC will plan and host a roundtable discussion of top leaders in behavioral health integration and shared decision-making in order to develop recommendations for how to enhance the engagement of patients using shared decision-making tools in behavioral health settings.
This contract, set to begin July 1, will leverage PCC’s existing behavioral health integration workgroup for guidance and planning of the roundtable. Intended objectives of the project include:
exploring enablers and barriers to shared decision-making, specifically in behavioral health, to create recommendations on how to increase its use
informing future research agendas of PCORI and other research institutions
producing a webinar and related communications that can be disseminated to the broader behavioral health and primary care communities to increase knowledge and uptake of evidence-based shared decision-making best practices.
For more information on this project or to get involved, contact Alyssa Neumann at aneumann@thepcc.org.
Executive Member Spotlight: Innovaccer
This is a new regular feature of PCC’s monthly enewsletter. We plan to focus on a different Executive Member of PCC every month and spotlight some of the current campaigns, initiatives or work in primary care that they’re implementing.
Would you like to appear here? Would your organization/company like to be featured in a future issue of this newsletter? Do you have exciting, interesting or useful work to talk about or resources that other members may find useful? Be in touch with us.
Innovaccer has been a PCC Executive Member since October 2018. Based in San Francisco with offices across the U.S. and Asia, it is a healthcare technology company that’s known for its Data Activation Platform, which provides integration and analysis of data for physicians.
Many leaders who have been very involved in the PCC are now in the leadership of Innovaccer or on its Strategic Advisory Council. Among them as Innovaccer’s Chief Transformation Officer is Paul Grundy, MD, MPH, FACOEM, FACPM, the Founding President of PCC (the Patient-Centered Primary Care Collaborative, as it was known at its founding in 2006), who is also well-known as the "Godfather of the Patient-Centered Medical Home."
Innovaccer’s current work includes:
Launching the Care as One Community, a “one-stop community for healthcare professionals to connect with like-minded peers on the go.” It’s a place for them to build their network locally and nationally, learn from thought leaders, explore educational avenues, and stay on top of industry trends. It’s a virtual community for the healthcare community with a portal that’s similar to popular social media channels.
Publishing “What COVID-19 Means to American Healthcare: Trends, Impacts, Predictions, and the Road Ahead,” a report that reviews the shortcomings that COVID-19 uncovered in the American healthcare system and that predicts near-term utilization projections for healthcare resources. Authored by Grundy, the report also explores the usage of virtual care and telemedicine IT solutions that emerged during the pandemic.
Launching the free COVID-19 Management System to support government and healthcare organizations’ care of patients during COVID-19. Previously announced by PCC, the system helps providers to manage incoming patients and connect with them through remote assessments, virtual care, education, automated outreach and guidance.
New Members of PCC's Board of Directors
The PCC welcomes these two members who were recently elected to its board:
Sinsi Hernandez-Cancio, JD
Vice President for Health Justice, National Partnership for Women and Families
Sinsi Hernández-Cancio has served in her current role since March 2020. She previously served as the founding director of Families USA’s Center on Health Equity Action for System Transformation, where she led efforts to reduce disparities in healthcare outcomes and advance health equity.
She worked on building a thriving and vocal health-equity movement to protect the gains of the Affordable Care Act and leverage health care and delivery system transformation to reduce disparities.
She served on the Addressing Disparities Advisory Panel for the Patient-Centered Outcomes Research Institute (PCORI) and the Robert Wood Johnson Foundation’s State Strategies Advisory Committee.
Her advocacy career began as a Georgetown Women’s Law and Public Policy Fellow at the Women’s Rights Project of Human Rights Watch. Later, she advised and represented two Puerto Rico governors on federal health and human services policies in Washington, D.C. She was a senior health policy analyst for the Service Employees International Union (SEIU) and National Campaign Coordinator for SEIU’s Healthcare Equality Project. Bilingual and bicultural, she speaks across the country on health care. She is also a participant of the Allies Reaching for Community Health Equity Public Voices Fellowship with The OpEd Project. Ms. Hernández-Cancio earned an A.B. from Princeton University’s Woodrow Wilson School of Public and International Affairs and a J.D. from New York University School of Law, where she was a Hays Civil Rights and Civil Liberties Fellow.
John G. Murtha, MPH, MBA
Global Health Plan Industry Segment Leader, IBM
John Murtha sets the strategic direction for IBM’s Global Health Plan Segment and works with priority accounts envisioning next generation health plans, including single-payer initiatives globally.
IBM's Global Government, Healthcare & Life Sciences group is charged with working with IBM’s Distinguished Engineers, Brand Leaders, Quantum Network, and extensive portfolio of patented technologies to determine how best to deploy these to deliver Healthcare’s Quadruple Aim. A critical element of IBM’s long-term strategy is industry focus – and creating platforms that enable providers of care to make optimal decisions for their patients that are founded on research and members' personal preferences.
A 20-year health plan industry veteran, John has led several large-scale transformation initiatives that extensively used technology and re-engineered processes. Prior to joining IBM, he was the Chief Operating Officer with full profit and loss responsibility of VNS CHOICE Health Plans, a $1.7 billion entity that offered multiple Medicare and Medicaid lines of business, including Select Health and HIV Special Needs Plan with the highest HIV suppression rate in the country. John earned an MBA in finance as well as a Masters in Public Health in Effectiveness and Outcomes Research from Columbia University.
While the coronavirus has been deadly for tens of thousands of Americans, primary care, a vital foundation of a high-functioning health system, is also facing deathly blows. Layoffs and furloughs, sharply declining income, and high stress are some of the forces that have been battering primary care practices for months. Yet some practices are able to weather the COVID-19 storm better than others. We’ll look at how they are doing so, examining how they are paid, their existing care management and IT infrastructure, leadership and governance, and other factors. We’ll learn from the survivors by hearing from leaders at two primary care practices and their health plan counterparts.
Speakers:
Karolina Skrzypek, MD | Medical Director in Provider Engagement, Blue Cross Blue Shield of Michigan
Ewa M. Matuszewski | CEO and Co-Founder, MedNetOne Health Solutions
John Bennett, MD, FACC, FACP | President and CEO, CDPHP
(tentative) Adetutu Adetona, MD | Owner and President, Lansingburgh Family Practice P.C.
Moderator: Julie Schilz, BSN, MBA | Senior Director, Commercial Health Innovation, Mathematica
June 29
The three panelists on June's webinar set the stage by saying behavioral health is an issue that we as health care, primary care and a country in general need to start talking about. The current health crisis has exacerbated several problems that existed before the pandemic, such as alcohol and drug abuse and suicide, but this crisis is an opportunity to start making stronger links among the public health, primary care and behavioral health communities. The webinar provided some basic practical steps toward starting on these reforms.
Speakers:
Jack Westfall, MD, MPH | Director, Robert Graham Center
Benjamin Miller, PsyD | Chief Strategy Officer, Well Being Trust
Kelly Davis | Director of Peer Advocacy, Supports, and Services, Mental Health America
Moderator: Arthur C. Evans, Jr., PhD | Chief Executive Officer and Executive Vice President, American Psychological Association
May 26
May's webinar featured three different perspectives on primary care and how crucial it is in meeting patients' needs during the pandemic as well as how vital it will be after the health crisis in the long-term in order to lower healthcare costs and achieve better health outcomes. The panelists discussed what would need to happen policy-wise, financially and in other ways for more patients to have access to primary care.
Panelists:
Michael Fine, MD | Chief Health Strategist for the Cities of Central Falls and Pawtucket, Rhode Island, and Medical Director of Beat COVID-19, the two-city strategy to stop the spread of COVID-19
Grace-Marie Turner | President, Galen Institute
Rachel Prusak | State Representative, Oregon House District 37
Moderator: Ann Greiner, MCP | President & CEO, Primary Care Collaborative
April 15
April's webinar highlighted ways that primary care is responding to COVID-19. Panelists gave an overview of the development of the pandemic and provided different perspectives of primary care’s response, including virtual visits, primary care in a rural setting, and responding to the pandemic through a health equity lens.
Panelists:
Darilyn Moyer, MD, FACP, FRCP, FIDSA | Executive Vice President & Chief Executive Officer, American College of Physicians
Ian Tong, MD | Chief Medical Officer, Doctor On Demand
April Joy Damian, PhD, MSc, CHPM, PMP | Associate Director, Weitzman Institute
Michael Tuggy, MD | Clinical Professor, University of Washington School of Medicine
Moderator: Beverley H. Johnson, President & CEO, Institute for Patient and Family-Centered Care
On April 16, Health Affairs hosted a webcast event focused on its latest report on social services and health. There is growing attention in the health sector to understanding and addressing the social factors that play a role in people’s health. Yet most programs designed to meet social needs are completely separate from those designed to meet healthcare needs. Learn from a panel of experts about how integrating social services and health care can increase equity for all.
On April 21, the Bipartisan Policy Center’s Rural Health Task Force released a new report that offers practical and politically viable solutions for fixing the current healthcare crisis in rural communities. The recommendations aim to stabilize hundreds of rural hospitals that are at risk of closing and create pathways for transforming these facilities into models of care that best meet a community’s needs. Members of the task force discussed how these policy proposals will also stem closures of obstetric units, promote the uptake of value-based care, provide incentives for clinicians to stay in rural areas, and remove barriers to telehealth.
On April 23, Health Affairs hosted the second webcast from its three-part series on social services and health. Earlier in the month, we discussed how integrating social services and health care can boost equity. This webinar is about learning from a diverse panel who is working on this effort. They discussed what works and what doesn’t, based on evidence from the field.
The Pacific Business Group on Health (PBGH), American Academy of Family Physicians (AAFP), and the Partnership to Empower Physician-Led Care (PEPC) presented a virtual Capitol Hill briefing on April 30. Giving the opening presentation was Rebecca Etz, Ph.D., co-director of The Larry A. Green Center, which has been conducting a weekly survey of primary care clinicians and their response to COVID-19. PCC has been closely involved in the survey and has been distributing the results weekly. After Dr. Etz’s powerful presentation (read her written remarks) in which she set the stage and described the crisis that primary care is in, other panelists, including frontline clinicians and national policy experts, described the impact of the pandemic on practices and patient access, the potential long-term impact of the collapse of the primary care system, and how employers and other payers are responding to the crisis.
On May 14, the Primary Care Development Corporation (PCDC) hosted Farzad Mostashari from Aledade and Dave Chokshi from New York City Health + Hospitals to discuss strategies and best practices for primary care’s response to COVID-19. Moderated by PCDC’s CEO, Louise Cohen, the panelists discussed the unique challenges primary care is facing—for both in-person and telehealth visits—as well as what providers need right now to combat the pandemic.
On May 20, the National Alliance of Healthcare Purchaser Coalitions hosted a webinar on the effects the COVID-19 pandemic and related stay-at-home orders are having on the mental health of individuals across the U.S. The Northeast Business Group on Health provided an analysis of how digital tools can help combat this mental health fallout and how employers can ensure they are providing the right tools for their employee populations.
On May 21, the Primary Care Development Corporation (PCDC) hosted the second in its series of COVID-19 webinars to discuss strategies to reboot and reopen the primary care system. Speakers discussed clinical practices, health system infrastructure, and policy changes needed to support primary care in combating the pandemic. Also addressed were what primary care needs to prepare for a second wave of COVID-19 and how providers can address deferred care to ensure health equity.
On June 23, the Primary Care Development Corporation (PCDC) hosted a virtual town hall to discuss the impact of COVID-19 on healthcare providers and organizations. Providers, inclusive of all levels of healthcare staff, are being asked to manage challenges and develop creative solutions for providing continuity of care in the context of the pandemic. Experts representing a diversity of healthcare settings shared their experiences and lessons learned.
On June 24, CMS hosted a virtual listening session in order to understand gaps in payment, coverage, access, and/or availability and effectiveness of communication and information that may contribute to COVID-19 disparities among CMS beneficiaries.
On June 25, the National Alliance of Healthcare Purchaser Coalitions hosted a virtual town hall in order to take a renewed look at the influence of race on the health and wellbeing of employees and their families across various organizations and communities within our society. This provided a preliminary conversation for a variety of discussions on race, health, and equity in order to begin to address racial injustices within our health system.
Missed the Primary Care in the Time of COVID-19 Twitter Chat? Here’s How You Can Revisit It
Saved Q&A Contains a Wealth of Resources, Articles, Programs and Initiatives
On June 18, PCC joined many other leading organizations in the primary care community in an hour-long chat on Twitter about the current and future state of primary care during the coronavirus pandemic.
If you missed the chat, you can read the saved Q&A on Twitter under the hashtag #PrimaryCareCovidChat. Or even if you were part of the chat, you may find a reading of the Q&A at your own pace is more beneficial, since the conversation was very fast-paced and included many answers to each of the nine questions that were posed. You don’t have to have a Twitter account/be on Twitter to read the conversation.
In addition to PCC, the hosts/participants included: Mathematica, The Larry A. Green Center, 3rd Conversation/X4Health, American Association of Nurse Practitioners, AcademyHealth, California Health Care Foundation, Commonwealth Fund, Milbank Fund, Primary Care Development Corporation, Well Being Trust, National Center for Integrated Behavioral Health at the University of Pennsylvania School of Medicine, along with many other primary care organizations and leaders.
Participants offered many opinions and insights in their answers. Perhaps most beneficial in the reading of the Q&A after the event is discovering many resources that many of the participants provided in their answers—helpful articles and organizational programs and initiatives, for example.
The chat covered a range of topics, including primary care organization, delivery, financing, and workforce during the COVID-19 pandemic.
Primary care practices are projected to lose more than $65,000 in revenue per full-time physician this year, following drastic declines in office visits and fees for services from March to May during the COVID-19 pandemic, according to this study led by researchers in the Blavatnik Institute at Harvard Medical School. The revenue lost by primary care practices across the U.S. will add up to a total shortfall of $15 billion.
Practices currently using behavioral health integration face cultural, informational and financial barriers. Providing technical support and improved payment models may enhance the long-term sustainability of the approach, according to a new RAND/AMA study. However, that support must be tailored and context-specific, the authors warn.
Public attention during the pandemic has focused on hospitals; that’s where the challenge is greatest, the personal drama highest, and where people are dying. Meanwhile, however, the primary care practices - the ones public service announcements refer to when they say “see your doctor” - is collapsing.
Membership Has Its Privileges
Executive Membership in PCC comes with many benefits. Becoming an Executive Member allows you to:
connect and network with organizations and individuals from different stakeholder groups who share a common commitment to furthering primary care
receive the monthly member-only e-newsletter that highlights policy developments, upcoming events, and key issues related to primary care
join and become an active participant in PCC's three workgroups
receive discounts on event registrations
contribute to PCC’s policy and advocacy work
sponsor events and initiatives
do much more
Visit the Executive Member pagefor more information, and watch the short (less than 2 minutes) videobelow that features organizations and why they chose to become Executive Members.
If you have questions about the membership process or benefits or would like to schedule a conversation, please contact:
PCC's Online Event Calendar These and other webinars and conferences are listed on PCC's event calendar on its website. Updated regularly, the calendar lists events of interest to the primary care community.
Hosted by the Forum on Mental Health and Substance Use Disorders, National Academies of Sciences, Engineering, and Medicine. Examining approaches to facilitate the delivery of essential components of care for people with mental health and substance use disorders in primary care settings. Remaining webinars:
July 29, 2020 | Virtual conference (changed from in-person event)
National surveys show that mental health has suffered significantly as a result of COVID-19, with U.S. adults reporting unprecedented levels of negative emotions, including worry, sadness, anger, and loneliness. As businesses shift to plans for reopening, support for employee mental well-being, emotional recovery, and ongoing resilience will be critical. Join the St. Louis Area Business Health Coalition and over 300 employer and health care leaders for a virtual conference to discuss innovative strategies to increase awareness, decrease stigma, and create a culture of health, both during and after a global pandemic.
Primary Care Investment 2.0—State Innovation (for PCC Executive Members and State Leaders Only )
December 2, 2020 | online
This session will build on PCC’s first primary care investment workshop hosted in fall 2018. This year’s convening will bring together PCC Executive Members along with state leaders, policymakers and advocates to highlight lessons learned, engage with each other, tackle emerging issues, and discuss shared agendas for advancing investment in primary care. PCC will also release its 2020 Evidence Report at this event.
May webinar highlights: “The Commercial Market: Alternative Payment Models for Primary Care” Nate Murray explains w… https://t.co/KX9Wi2w6oY —
1 year 2 months ago