A group of healthcare organizations have come together to advocate for policies that support independent practices moving to risk-based care models.
A group of healthcare organizations have come together to support independent physician practices in their shift to value-based care through the Partnership to Empower Physician-Led Care (PEPC).
The founding members of the coalition—Aledade, the American Academy of Family Physicians, California Medical Association, Florida Medical Association, Medical Group Management Association, and Texas Medical Association—will advocate for policies that support independent practices moving to risk-based care models.
“PEPC is dedicated to supporting value-based care to reduce costs, empower patients and physicians, and increase access to care for millions of Americans through a competitive healthcare market,” stated a press release from the coalition. The press release noted that independent physicians make up nearly half of the physician workforce, but their role in leading the shift to value-based care is often overlooked.
The coalition will focus on 4 policy priorities: advancing physician-led alternative payment models; ensuring an equitable policy framework that promotes choice and provider competition; creating new opportunities for physicians in commercial markets, such as Medicare Advantage; and supporting consumer-directed care.
The 4 policy priorities, as well as the idea behind the coalition, stem from a letter to CMS Administrator Seema Verma in December 2017 from several of the organizations encouraging CMS to initiate 4 principles in order to expand opportunities for physician-led groups, explained Kristen McGovern, executive director of PEPC, in an interview with The American Journal of Managed Care®.
“One catalyst of the coalition was that we’ve seen the results that physician led value-based care organizations can achieve,” said McGovern. An HHS Office of Inspector General Report on the Medicare Shared Savings Program (MSSP) in August 2017 found that high-performing accountable care organizations (ACOs) were more likely contain only physicians. Approximately 45% of high-performing ACOs in 2015 were physician-led ACOs.
A goal of the coalition is to support physician-led models, especially ones that incorporate risk appropriate for independent practices, said McGovern. She gave the example of the Track 1+ model under MSSP, where there is an option for practices to take risk on their Medicare population, rather than their total population.
The coalition will focus on both education and advocacy. On the education side, PEPC will focus on tools such as case studies and examples of practices that are moving toward value-based care as well as lessons learned. On the advocacy front, the coalition will looking toward forthcoming regulations.
“We hope to keep independent practice at the front of policy makers’ minds,” said McGovern. “So, as their thinking about new payment policies or models, that they consider the impact and appropriateness of some of the policies and models for independent practices.”