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ICYMI: Notes from the field for May 2020 

DATE: May 31, 2020

As the COVID-19 pandemic enters its third month in the U.S., the healthcare industry continues to focus on news related to the crisis. Nevertheless, as the wheels of healthcare policy reform roll on, updates to value-based care policy continue to be announced.

The continuing COVID-19 crisis

  • How has the $50 billion Provider Relief Fund portion of the CARES Act been distributed? We’ve analyzed how the funds were distributed across the states, including in rural settings.
  • Responding to appeals from the American Hospital Association and the National Association of ACOs, CMS included provisions in an interim final rule to help providers continue their participation in ACO models throughout the crisis. Following the initial post-COVID-19 predictions that ACO participation would plummet, will this incentivize participants to stay in the program?
  • How long can providers work without pay? A virtual Capitol Hill briefing by primary care practice leaders revealed financial stress reaching the breaking point, Healthcare Innovation reported. Will COVID-19 jumpstart the evolution of primary care?

Value-based care updates

  • Based on feedback received since its original model was released in 2015, the American Society of Clinical Oncology updated the Patient-Centered Oncology Payment model to create a flexible, comprehensive plan of alternative payment, preparing providers for “full practice transformation.”
  • Predictive modeling, expertise in patient transitions and a quick pivot to telehealth: according to NAACOS, due to their care coordination and infrastructure, ACOs are uniquely positioned to identify vulnerable patients at high risk for COVID-19.
  • How can primary care practices thrive — and better serve their patients — under value-based payment? Here’s one perspective from Modern Healthcare.
  • As hospitals pause elective procedures during the pandemic, their struggles highlight the weaknesses in a volume-based system. In this interview with FierceHealthcare, the CEO of Blue Cross and Blue Shield of Minnesota suggests that the silver lining in this crisis will be a serious exploration of value-based care models.

Other news

  • Although consideration of social determinants of health has become widely accepted and government initiatives for SDoH are increasing, physicians have been slow to link illnesses and chronic conditions to the environmental conditions in which people live, according to Patient Safety & Quality Healthcare.
  • With news of the extension to the Comprehensive Care for Joint Replacement program comes changes in baseline pricing and more challenges for hospitals. CMS will determine target prices solely based on regional historic spending by region, starting with performance year 4.