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What We’re Watching: January 22, 2019

MAKING WAVES IN THE PRIVATE SECTOR

  • Blue Cross Blue Shield of North Carolina (BCBSNC) entered into value-based agreements with five of the state’s largest health systems.
  • CMS released its 2019 Medicare Advantage (MA) enrollment information, with MA plans continuing to outpace traditional fee-for-service growth.
  • The CEO of CVS – Larry Merlo – discussed a variety of subjects at the National Press Club, including the use of pricing data to push prescribers to lower-cost alternatives, the CVS store of the future that lets patients rely more heavily on pharmacists and “concierge” services, and the company’s $100 million 5-year program to address the social determinants of health.

What we’re saying: As this administration continues to shift risk from government payers to private entities, we’ll continue to see more examples of what BCBSNC is doing. MA plans will also become even more attractive. Furthermore, we see innovation in care delivery as table stakes as patients increasingly look for more convenient, efficient and integrated ways to access health services. Premier experts discuss these moves and the implications for healthcare providers, including increased provider shortages, more vertical integration activity and an extreme focus on consumerism.

IT’S NOT BRAIN SURGERY

Awareness continues to grow as more people openly discuss the scourge known as physician burnout. A recent Harvard study referred to the issue as a “public health crisis that urgently demands action by healthcare institutions, governing bodies, and regulatory authorities.” The study concluded that if burnout goes unaddressed, “the very provision of care” will be threatened, along with the erosion of “the mental health of physicians across the country.”

What we’re saying: The report found that the biggest contributing factor to burnout are the two to three additional hours that physicians spend on EHRs every day (often referred to as “pajama time”). The study recommendations closely align with what Premier has found
in our work with physician practices and health systems:

  • Adoption of common RFP language specifying and requiring inclusion of a uniform healthcare application processing interface (API) that enable time-saving apps within the EHR workflow when evaluating HIT contracts.
  • Encouraging independent software developers to advance a range of apps that can operate with most – if not all – certified EHR systems.
  • Pushing for long overdue federal policies that advance new standards and address the usability and workflow concerns of physicians.

EXTENSION NEEDED

Premier was among a group of healthcare provider organizations that urged CMS to extend the deadline to apply to the Medicare Shared Savings Program (MSSP) from February 19th to March 29th.

What we’re saying: Premier expressed concern to CMS in our initial comments on the proposed MSSP redesign back in October. We believed then (as we do now), that implementation issues could arise if CMS rushed the application process. It is important that the agency and participants have enough time to prepare for an application cycle after the final rule. Premier previously asked that CMS delay the July 1, 2019 start of the program and offer a one-year extension to all current ACOs ending their agreements if CMS is not ready to implement a new model. We’ve been working with several organizations on their notice of intent to apply for this round.

IN CASE YOU MISSED IT

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members.

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