Category: Press Releases

Thomas Cornwell, MD, Transitions Roles at HCCI and Joins VillageMD

Post author By Jim Nonneman
Post date March 2, 2020

Founder of Home Centered Care Institute transitions from CEO to Executive Chairman and takes on new role with VillageMD

Schaumburg, IL, March 2, 2020

The Home Centered Care Institute (HCCI) announced today that its founder, Dr. Thomas Cornwell, will transition his role with the organization from Chief Executive Officer to Executive Chairman, effective March 9, 2020. At that time, he will also become the Senior Medical Director of Village Medical at Home, part of VillageMD.

Since founding HCCI, Dr. Cornwell has played a critical role in fulfilling the organization’s vision to spread home-based primary care (HBPC) to more patients by generating substantial awareness of HBPC and the need for expanding house call programs and the workforce.

HCCI has also played a role in the continuation of the Independence at Home Medicare Demonstration and the Centers for Medicare & Medicaid Services’ New Payment Models; educated over 500 unique learners and 260 HBPC practices; introduced a consulting practice focused on practice management and clinical care; created six HCCI Centers of Excellence for Home-Based Primary Care™; assembled a national faculty of HBPC leaders; and taught over 1,000 students and health system leaders at three medical universities in China along with partnering with Shandong University in Jinan to create an HCCI HBPC training center.

“I am incredibly proud of the team at HCCI and know it is in good hands and well-positioned for the future,” said Dr. Cornwell. “I am excited to be joining Village Medical at Home and combining their operational excellence with my twenty-five years of HBPC experience and clinical skills to further spread house calls nationally.”

Taking on his new role with Village Medical at Home means that Dr. Cornwell will no longer practice with Northwestern Medicine HomeCare Physicians. “I remain forever thankful for Northwestern Medicine’s support of HomeCare Physicians,” said Cornwell. “The numerous awards, media exposure, and national recognition we have received as a house calls practice – and, most importantly, the number of patient and caregiver lives we’ve been able to touch – are all a result of Northwestern’s incredible support.”

HCCI’s Board plans to review the existing leadership structure at their next meeting. In the interim, Julie Sacks, Chief Operating Officer, will continue to manage the daily operations of HCCI. Sacks shared her thoughts on the transition, saying, “Without Dr. Cornwell and our funders, there would be no HCCI. He had the incredible vision and passion to establish an organization that is transforming our health care system. I also consider it an honor to help steward HCCI through this important transition.”

Richard Maybury, Chairman of the Board for HCCI, also shared his perspective, adding, “Dr. Cornwell has been caring for patients in their homes for over 25 years, so his new role is a natural extension of that work. At the same time, HCCI is well-positioned for the future with a strong core of proprietary HBPC education delivered through multiple channels, a growing consulting practice, a key role in HBPC advocacy, a national network of leading academic healthcare institutions and HBPC faculty, and the right combination of experienced and tenured leaders and staff in place to take the organization forward.”

As Executive Chairman, Dr. Cornwell will be a member of the board; continue to act as a strategist; represent HCCI to the public, industry and media; and play a continued role in the organization’s ongoing growth and improvement, including fundraising.

Home Centered Care Institute

The Home Centered Care Institute (HCCI) is a national non-profit organization focused on advancing home-based primary care to ensure that medically complex and homebound or home-limited patients have access to high-quality care in their homes. HCCI works with leading academic medical centers, health systems, and industry experts to raise awareness of and advocate for expanding the model by growing the home-based primary care workforce through education and training and developing a research-based model for sustainable house call program implementation and growth. For more information, visit www.hccinstitute.org and follow @HCCInstitute.

Northwestern Medicine

Northwestern Medicine is the shared strategic vision of Northwestern Memorial HealthCare (NMHC) and Northwestern University Feinberg School of Medicine to transform the future of healthcare and become a premier integrated academic health system. Each day, 33,700 clinical and administrative staff, medical and science faculty, and medical students come together with a shared commitment to superior quality, academic excellence, scientific discovery and patient safety. For more information, visit nm.org.

VillageMD

VillageMD is a leading provider of healthcare for organizations moving toward a primary care-led, high-value clinical model. The VillageMD solution provides the tools, technology, operations, and staffing support needed for physicians to drive the highest quality clinical results across a population. VillageMD works with physician groups, independent practice associations, and health systems to improve quality, deliver a first-rate patient experience, and lower costs in the communities they serve. VillageMD will continue to grow its Village Medical brand and scale its Village Medical at Home offering. VillageMD has grown to include more than 2,500 physicians across nine markets and is responsible for approximately 500,000 lives and $3 billion in total medical spend in value-based contracts. To learn more, please visit www.villageMD.com.

Read the VillageMD press release here.

Read the HCCI Chairman of the Board letter here.

# # #

HCCI in the News News Press Releases

Chairman of the Board Letter

Post author By Jim Nonneman
Post date March 2, 2020

March 2, 2020
Chairman of the Board Letter

Thomas Cornwell, MD, Transitions Roles at HCCI and Joins VillageMD

On behalf of the Board of Directors, leaders and staff at the Home Centered Care Institute (HCCI), I wanted to share some exciting news with you. Dr. Thomas Cornwell, the founder and Chief Executive Officer of HCCI, will begin a new role as Senior Medical Director of Village Medical at Home, part of VillageMD, effective March 9, 2020. In this position, he will bring his experience, skills and passion from making over 33,000 house calls to VillageMD’s extensive provider network that serves over 500,000 patients in nine markets. With this change, Dr. Cornwell will no longer be HCCI’s CEO, but he will maintain a strong connection to the organization in his new role as Executive Chairman.

Dr. Cornwell has been providing home-based primary care (HBPC) for over twenty-five years, starting at a time when house calls were relatively rare. Well, they are most assuredly not as rare now – in part due to his vision, HCCI’s efforts, and as also evidenced by VillageMD’s expansion into the field. His original vision, supported by our funders, led to establishing HCCI, where he and a similarly passionate team have made great strides towards increasing access to HBPC by:

Generating substantial public and provider awareness of the importance of HBPC and the need for expanding the workforce.
Playing a role in the continuation of the Independence at Home Medicare Demonstration and the Centers for Medicare & Medicaid Services’ two New Payment Models: Primary Care First and Direct Contracting.
Educating over 500 unique learners and 260 HBPC practices through live workshops, pre-conferences, online courses, webinars and additional events and resources.
Introducing a consulting practice that supports new and existing HBPC programs through a focus on practice management and clinical care.
Creating six HCCI Centers of Excellence for Home-Based Primary Care™ with prominent national academic healthcare institutions and assembling a national faculty of HBPC leaders.
Teaching over 1,000 students and health system leaders at three medical universities in China and partnering with Shandong University in Jinan to create an HCCI HBPC training center.

I am excited about this change for two main reasons First, this new role will allow Dr. Cornwell to leverage his clinical experience and skills to an even greater extent while continuing to support HCCI and its mission to spread HBPC nationally. Second, I know HCCI has the people, infrastructure and partners in place to continue its excellent training and consulting, advocacy work, research, and focus on increasing public awareness, now and into the future.

In terms of roles, as Executive Chairman, Dr. Cornwell will be a member of the board; continue to act as a strategist; represent HCCI to the public, industry and media; and play a continued role in the organization’s ongoing growth and improvement, including fundraising. Our board will also review the existing leadership structure at our next meeting in March. In the interim, Julie Sacks, Chief Operating Officer, will continue to manage the daily operations of the organization ─ to include overseeing the senior leadership team and creating and ensuring the execution of the organization’s high-level strategies, new initiatives, and partnerships.

Due to his new role, Dr. Cornwell will no longer practice at Northwestern Medicine HomeCare Physicians. Dr. Cornwell remains forever thankful for the role Northwestern Medicine played in supporting him and HomeCare Physicians. Dr. Paul Chiang will continue to lead HomeCare Physicians and remain Senior Medical and Practice Advisor at HCCI.

The entire board wishes to thank Dr. Cornwell for his tremendous contributions and leadership as the CEO and is pleased to be able to continue to work with him in his new Executive Chairman role. Also, we want to congratulate him on joining VillageMD, a wonderful opportunity that further spotlights the increasing visibility of HBPC.

Finally, I personally want to thank Dr. Cornwell, or “Tom” as I call him, for his friendship and for everything he’s done to make house calls a valued and visible part of the healthcare landscape. Because, in the end, it’s all about taking care of a patient in their home ─ something I’m sure we all hope is available when we, and our loved ones, need it.

Read the VillageMD press release here.

Read the HCCI Chairman of the Board letter here.

Sincerely,
Richard Maybury
Chairman of the Board
Home Centered Care Institute

Press Releases

Home Centered Care Institute Awarded Grant to Bolster Home-Based Primary Care Workforce

Post author By Jim Nonneman
Post date November 12, 2019

The John A. Hartford Foundation grant to support education of providers and practices focuses on the most complex patients

SCHAUMBURG, IL, November 11, 2019 — The Home Centered Care Institute (HCCI) has been awarded a $385,000 grant to continue educating home-based primary care providers and practices by The John A. Hartford Foundation (JAHF). This award is part of a larger project, Moving and Scaling Home-based Primary Care Phase II: Quality, Training, and Advocacy, in which The John A. Hartford Foundation, a national private philanthropy dedicated to improving the care of older adults, is investing a total of $1.6M over the next three years.

The larger project also includes grants for a home-based primary care national practice directory being developed by the American Academy of Home Care Medicine (AAHCM) and a qualified clinical data registry and national learning collaborative for home-based primary care and palliative care through Massachusetts General Hospital and Johns Hopkins University School of Medicine. The overall goal of the three coordinated projects is to deliver measurably improved care that will lead to improved outcomes for home-limited patients and their caregivers.

Four million vulnerable adults in the U.S. have difficulty obtaining, or are completely unable to access, office-based primary care because they are frail, chronically ill, functionally limited and/or homebound or home-limited. These individuals often use the emergency room instead of visiting a primary care office, resulting in escalating costs and poor health outcomes.

“With 10,000 baby boomers turning 65 every day and our population living longer with more chronic diseases, home-based primary care provides the best solution for a growing number of patients. When home-based primary care is integrated into a value-based health care system, it both improves patient outcomes and lowers health care costs,” explains Dr. Thomas Cornwell, CEO of HCCI, founder of Northwestern Medicine’s HomeCare Physicians and a practicing house call doctor. “In terms of costs, the most complex patients are also often the highest utilizers of acute care, constituting the majority of the 5 percent of U.S. patients who account for 50 percent of health care costs nationwide.”

During the next three years, HCCI will work with key partners to further develop and deliver HCCI’s education and training offerings around clinical and practice management topics. These offerings include live workshops, and online courses and technical assistance, along with access to the HCCIntelligence™ Resource Center, provided at no charge and also funded in part by the grant from The John A. Hartford Foundation. The Resource Center includes webinars, virtual office hours, and a hotline, as well as tools and tip sheets. The three-year HCCI project will also focus on establishing HCCI Practice Excellence Partners™, leading house call programs across the country offering opportunities for shadowing.

“We are very pleased to once again have the support of The John A. Hartford Foundation,” Dr. Cornwell added. “With this grant, we will provide critical education for providers and practices throughout the country, which will ultimately result in more patients having access to the care they need. Most important, these are often patients who, if HBPC weren’t available, wouldn’t be seeing a primary care provider at all.”

“Home-based primary care is age-friendly care, and it’s a clear win for payers, providers, patients, and family caregivers,” said Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation. “We are proud to work with HCCI and our other partners to develop well-trained interdisciplinary primary care teams that help our most vulnerable older patients stay out of hospital and skilled nursing beds and exactly where they want to be… in the home.”

Home Centered Care Institute
The Home Centered Care Institute (HCCI) is a national non-profit organization focused on advancing home-based primary care to ensure that medically complex and homebound or home-limited patients have access to high-quality care in their home. HCCI works with leading academic medical centers, health systems and industry experts to raise awareness of and advocate for expanding the model by growing the home-based primary care workforce through education and training and developing a research-based model for sustainable house call program implementation and growth. For more information, visit www.hccinstitute.org and follow @HCCInstitute.

The John A. Hartford Foundation

The John A. Hartford Foundation, based in New York City, is a private, nonpartisan philanthropy dedicated to improving the care of older adults. Established in 1929, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregiving, and improving serious illness and end-of-life care. For more information, visit www.johnahartford.org and follow @johnahartford

Media Contact:

James Warda
Home Centered Care Institute (HCCI)
[email protected]
847-204-2555

Press Releases

Physician and Researcher Recognized for Contribution to the Field of Home-Based Medical Care

Post author By Jim Nonneman
Post date November 11, 2019

American Academy of Home Care Medicine Presents Annual Awards:

Paul Chiang, MD, named “House Call Physician of the Year”
Aaron Yao, PhD, named “Researcher of the Year”

SCHAUMBURG, IL, November 7, 2019 — The American Academy of Home Care Medicine (AAHCM) recognized a physician and researcher for their contributions to the field of home-based primary care at the organization’s October meeting in Rosemont, IL.

AAHCM awarded its House Call Physician of the Year designation to Paul Chiang, MD, medical director and practicing physician of Northwestern Medicine’s HomeCare Physicians and senior medical & practice advisor for the Home Centered Care Institute (HCCI). The House Call Physician of the Year award is given to a physician member of the AAHCM who provides the highest quality of service and innovative programs, demonstrates excellence and has continued dedication to the field of house call medicine.

“Dr. Chiang has made more than 32,000 house calls to 2,900 patients in his 19-year career,” said Tom Lally, CEO and CMO of Bloom Healthcare in Colorado and the chair of AAHCM’s Annual Awards Committee, in announcing the award at the meeting. “He also enjoys teaching students, is passionate about bringing care to those who are homebound and was previously named one of the 50 ‘unsung heroes’ in the 50-year-history of Central DuPage Hospital. At the Home Centered Care Institute (HCCI), Dr. Chiang helps develop curriculum, teaches providers, and presents locally and nationally on the need for and benefits of home-based primary care.”

“I’m deeply honored to be the recipient of this award,” Dr. Chiang said. “For me, it is really recognition of the entire field of house call providers who focus on bringing care to our patients, advancing the field and helping house call medicine become even more mainstream.”

The academy awarded its Dan Gilden Creative Investigator designation to Aaron Yao, PhD, lead researcher for HCCI. The Dan Gilden Creative Investigator award is given to a member of AAHCM whose research demonstrates innovation in all areas of their work as they help to advance home care medicine.

In announcing Dr. Yao’s award, Lally explained, “House call medicine cannot advance without continued investigation into improving the value that we all create for patients, payers and the community. That is why Dr. Yao’s work at HCCI, in addition to his work with Shandong University in China and the University of Virginia School of Medicine, has been so critical. In these roles, time and again, he has focused on increasing the availability and quality of home care.”

“I’m thankful to all of my mentors and colleagues,” Yao said. “I’m excited to work on improving home care medicine in the U.S. and internationally, especially for frail and homebound patients in low- and middle-income countries. Health care and science can build many bridges across people and nations and I’m proud to play a small role in helping us unite.”

“We’re very proud of Dr. Chiang and Dr. Yao,” added Dr. Thomas Cornwell, CEO of HCCI, founder of Northwestern Medicine’s HomeCare Physicians and a practicing house call doctor. “Together, they help us spread awareness about home-based primary care and build a workforce of providers and practices to make this model of care more accessible. In doing so, they bring a real commitment and caring to their work.”

“These awards represent the highest professional honor from our organization, selected by a committee of peers.” said Theresa Soriano, MD, MPH, president of AAHCM. “We are thrilled to be able to recognize and celebrate Dr. Chiang and Dr. Yao, who embody the dedication, advocacy and idealism that have helped our field grow and thrive over the last thirty years.”

American Academy of Home Care Medicine
AAHCM is a professional organization serving the needs of physicians, health professionals, and organizations committed to improving care of patients in the home. AAHCM delivers on the promise of interdisciplinary, high-value health care in the home for all people in need by promoting the art, science, and practice of home care medicine. The AAHCM membership is composed of physicians, medical directors, nurse practitioners, physician’s assistants, registered nurses, social workers, practice administrators, and residents/students working in the field of home care medicine. For more information on AAHCM, please visit www.aahcm.org.

Northwestern Medicine
Northwestern Medicine is the shared strategic vision of Northwestern Memorial HealthCare (NMHC) and Northwestern University Feinberg School of Medicine to transform the future of healthcare and become a premier integrated academic health system. Each day, 33,700 clinical and administrative staff, medical and science faculty, and medical students come together with a shared commitment to superior quality, academic excellence, scientific discovery and patient safety. For more information, visit nm.org.

Media Contact:

James Warda
Home Centered Care Institute (HCCI)
[email protected]
847-204-2555

HBPC in the News HCCIntel Legislative News Practice Management Press Releases

CMS Announces Request for Applications for Primary Care First Model Options

Post author By Jim Nonneman
Post date October 28, 2019

CMS Announces Request for Applications for Primary Care First Model Options

(Highlights for Consideration included below)

CMS released the Request for Applications (RFA) for the Primary Care First (PCF) and Seriously Ill Population (SIP) models last Thursday, October 24. The practice application period also started that day while the deadline to apply via the live portal is January 22, 2020.

The model will now begin in January 2021 (a delay of one year from the originally anticipated start date). CMS will select practices and payers during Winter/Spring 2020 and will onboard participating practices and payer partners to the model from July to December 2020.

Following are important highlights of the new program for practices to consider:

Fees and Measurements

Under PCF General, the primary care flat visit fee will be reduced to $40.82.
HCC Risk Group 4 will be the highest-level risk group with a payment of $175 Per Beneficiary Per Month (PBPM).
Practice risk groups 3 and 4 will not use the acute hospitalization performance measure; instead, performance for these groups will be measured on the Advance Care Plan and Total Per Capita Cost (TPCC).

SIP

SIP practices are expected to have an 8-month management and transition period for stabilization of their patients and then to transition them back to another primary care setting or practice.
- This is known as the average length of attribution (LOA).
- If the 8-month term is exceeded, a $50 PBPM reduction will apply to the monthly SIP payment through a quality adjustment.
SIP patients will require a face-to-face visit once every 60 days for them to remain attributed to the practice.
SIP payment redesign now states that after a practice conducts its initial face-to-face visit with the SIP patient, CMS will make a one-time payment of $325. With PCF, beginning the month following the initial visit, the practice will receive a $275 PBPM minus a $50 quality withhold that can be earned back with a potential quality bonus at the end of the first performance year.
SIP practices must describe the service area(s) in which they are interested in participating using zip codes and must define the maximum number of SIP patients the practice has the capacity and capability to manage.

Participation and Eligibility

Practices participating in the Independence at Home (IAH) Demonstration are eligible to participate even if it is not offered in the region(s) of the IAH practice.
Practices participating in the Comprehensive Primary Care Plus (CPC+) model cannot participate in 2021, however, they can participate in 2022.
Concierge practices, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are not eligible to participate.
Eligible practitioners are those practicing in internal medicine, general medicine, geriatric medicine, family medicine and/or hospice and palliative medicine.

Home Centered Care Institute Support

If you have questions about these changes or other home-based primary care questions, you can contact our HCCIntelligence™ Resource Center Hotline at 630-283-9222, 9:00am to 5:00pm (Central Time) Monday through Friday – or email us at [email protected]. The hotline and additional offerings in the Resource Center, including monthly webinars, virtual office hours, and tools and tips sheets are available at no charge due in part to a grant from The John A. Hartford Foundation.

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Payment Reform Paves The Way For Expanding Home-Based Primary Care

Post author By Jim Nonneman
Post date May 2, 2019

May 2, 2019 | Home Centered Care Institute

The field of home-based primary care (HBPC) received extraordinary news as the US Department of Health and Human Services (HHS), in collaboration with the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI), announced its groundbreaking CMS Primary Cares initiative in Washington, D.C.

CMS Primary Cares aims to improve quality, improve patient experience of care, and reduce expenditures by increasing patient access to advanced primary care services. This revolutionary payment model includes several elements specifically designed to support practices caring for patients with complex chronic needs or serious illness, the patient population that can benefit so dramatically from home-based primary care.

About 4 million vulnerable adults in the United States have difficulty obtaining or are completely unable to access office-based primary care because they are frail, chronically-ill, functionally-limited and/or homebound. In desperation, these individuals often use the emergency room as their primary care physician. Since many of these patients have multiple comorbidities, ED visits frequently spiral into a lengthy hospital admissions.

“With 10,000 baby boomers turning 65 every day and our population living longer with more chronic diseases, home-based primary care provides the optimal solution for a growing number of patients as part of a value-based healthcare system,” notes Dr Thomas Cornwell, a practicing home-based primary care physician and Founder and CEO of HCCI. “Beginning in 2020, the CMS Primary Cares initiative will reduce barriers to entry and create a financially stable model for hospital systems and practices to bring quality care to the patients who need it most.”

“Since 2017, HCCI has partnered with leading academic centers and health systems to provide high-quality two-day training programs using the nation’s first comprehensive curriculum for home-based primary care,” shares Melissa Singleton, HCCI’s Vice President of Education & Research. “We train the entire team – physicians, nurse practitioners, physician assistants, social workers, practice managers, and others. And they come to us from a diverse range of specialties, including internal medicine, family practice, geriatrics, and more.”

Dr. Cornwell adds, “With the new CMS Primary Cares initiative, we stand a real chance of attracting more providers to the field – creating universal access to best practice house call programs, making home-based primary care the national standard for treating medically complex patients who are better cared for in the home.”

HHS Secretary Alex Azar lauded the CMS Primary Cares initiative as a historic first step toward a much bigger vision, even broader than value-based care. That vision is a healthcare system where every American patient feels she’s being treated like a person, not a number; where your doctor has one focus: not what procedures to order or how to bill you for them, but how to keep you healthy and well.

HCCI applauds and supports the diligent efforts of HHS Secretary Alex Azar, CMS Administrator Seema Verma, CMMI Senior Advisor to the Secretary Adam Boehler, AAHCM (who has led the charge on advocacy for our field), USMM, Centene, Aspire, Landmark, John A. Hartford Foundation, and all the provider organizations around the U.S. who have helped make this possible.

If you are interested in learning more about HCCI or supporting the future of HBPC, visit www.hccinstitute.org.

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Video Link:
Eric De Jonge, MD., President of the American Academy of Home Care Medicine shares insight about the new payment models: http://bit.ly/CMSPrimaryCares

About HCCI

The Home Centered Care Institute (HCCI) is a national non-profit organization focused on advancing home-based primary care (HBPC) to ensure that chronically ill, medically complex and homebound patients have access to high-quality care in their home. HCCI works with leading academic medical centers, health systems and industry experts to raise awareness of and advocate for expanding the HBPC model by growing the HBPC workforce through education and training and developing a research-based model for sustainable house call program implementation and growth.

Find out more at www.hccinstitute.org.

Media Contact:

Julie Sacks
Home Centered Care Institute (HCCI)
[email protected]
630-283-9230

Download a copy of the press release

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New CMMI Models Announced to Support Primary Care for People with Complex Chronic Illness

Post author By Jim Nonneman
Post date April 24, 2019

Secretary of Health and Human Services Alex M. Azar CMS Primary Cares Press Conference

4/24/19 | aahcm.org

The American Academy of Home Care Medicine (AAHCM) is pleased to share initial details on two new Alternative Payment Models (APMs) that promote primary care of Medicare beneficiaries with complex, advanced illness. The high-level outlines of these new APMs were announced on April 22 by the Center for Medicare and Medicaid Innovation (CMMI). The Academy’s media statement is available here. These APMs are part of a new CMS Primary Cares Initiative and will offer a choice of two new payment paths. The new payment demonstrations are meant to promote value-based care, with a voluntary shift of up to 25 percent of primary care Medicare fee-for-service patients to these new models. This e-alert summarizes the information CMS has released to date about the models. Several important details, such as exact payment amounts and patient eligibility criteria, remain to be announced. We will issue additional alerts to Academy members as soon as information is made available in the coming weeks.

Overview

The two new options, Primary Care First (PCF) and Direct Contracting (DC), will offer enhanced payment for home care medicine and other providers to provide primary care for people with advanced illness. The Academy, along with others, has worked closely with CMMI to develop this new payment model, with a focus on relevant quality measures for people with advanced illness and use of outcome-based payment methods. Many core principles of the successful Independence at Home (IAH) Demonstration are included in Primary Care First. Home care medicine providers and policymakers have learned much from IAH, thanks to the foresight of our champions on Capitol Hill and the CMS leadership. Read the full article

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HHS Secretary Azar Announces CMS Primary Cares – A Historic Turning Point In American Healthcare

Post author By Jim Nonneman
Post date April 24, 2019

April 22, 2019 | CMS.gov

This is the speech (as prepared) delivered by HHS Secretary Alex M. Azar, April 22, 2019 in Washington, D.C.

Good afternoon, everyone, and thank you so much for joining us. Thank you in particular to the American Medical Association for inviting us here to announce today’s news.

It’s appropriate to be at the headquarters of an organization with such a long history in American medicine, because I believe we’ll look back at what we’re announcing today as a historic turning point in American healthcare.

Today’s announcement is the culmination of years of work by many at HHS and throughout American healthcare.

When I announced last year that moving toward a value-based healthcare system would be one of my priorities as secretary, I was well aware that I was at least the fourth HHS Secretary to take this issue seriously, dating back through Secretaries Burwell and Sebelius to Secretary Leavitt, who first laid out the idea of paying for value rather than procedures.

It is only thanks to the efforts of my predecessors that we get to take this major step forward. Today also could not be possible without the enthusiastic engagement of so many physicians and other providers. That includes members of HHS’s advisory committee on physician-focused payment models, PTAC—a member of which we have here today, Kavita Patel.

That committee has analyzed a huge number of payment model ideas from physicians who are excited about innovation. Their work, including submissions from the American Academy of Family Physicians, the American Academy of Hospice and Palliative Medicine, and the Coalition to Transform Advanced Care, has inspired many significant aspects of the initiative we’re announcing today.

So what are we announcing? We’re launching CMS Primary Cares—an initiative with two sets of new payment models that will enroll a quarter or more of traditional Medicare beneficiaries and a quarter of providers in arrangements that pay for keeping patients healthy, rather than ordering procedures.

The Primary Care First path will allow smaller primary care practices to be paid a simple, flat stream of revenue for each patient. When a patient stays healthy and out of the hospital, these practices will get paid a bonus. But if the patient ends up sicker than expected, these practices will bear responsibility for the extra spending, up to a certain share of their practices’ revenue.

The other path, Direct Contracting, is more ambitious and aimed at larger practices. Just like in Primary Care First, when patients have a better experience and stay healthier, these practices will make more money. But if patients end up sicker, Direct Contracting practices will bear the risk for the extra health spending, not just at their own practice but throughout the system.

Providers will have greater flexibility to spend these resources how they want, allowing them to come up with innovative ways to care for patients—and receive significant savings if they keep patients healthier than expected.

Within this initiative, we will also have options for providers who want to focus on particular populations and particular serious illnesses—where there is huge potential for better health outcomes and more savings.

We’re also seeking input on another Direct Contracting model, to award a local entity a contract for an entire geographic area, covering all patients and providers in the area who want to opt into this arrangement.

This would provide an unprecedented ability for that local organization to negotiate better rates than Medicare does today, take responsibility for outcomes, and provide benefits that work for the local community’s needs.

Primary care is a small slice of health spending overall, but it has a significant impact on downstream costs and quality.

This initiative will radically elevate the importance of primary care in American medicine, move toward a system where providers are paid for outcomes rather than procedures, and free doctors to focus on the patients in front of them, rather than the paperwork we send them.

In just a minute, I’ll turn things over to Administrator Verma—I’m sorry to say, she is the one who sends doctors the paperwork, but she’s made sure there’s less and less of it every year.

Then we’ll hear from my senior advisor for value-based transformation and CMMI’s director, Adam Boehler. They’ll both discuss more details about this initiative and the range of options it’s going to offer for patients and clinicians.

Moving in this direction, toward value-based care, has been largely just a vision for so long. Now, value-based care is a reality, for a quarter of traditional Medicare beneficiaries in primary care, and a significant and growing number of patients in other settings as well.

This is the pivotal, hockey stick moment in paying for value in American healthcare.

This initiative will lay the groundwork not just for better care and lower costs in the $700 billion Medicare program and the $580 billion Medicaid program, but will also help drive innovation toward a new, patient-centered approach in our entire $3.5 trillion healthcare system. This initiative is specifically designed to encourage state Medicaid programs and commercial payers to adopt similar approaches.

I believe that true transformation is possible because of the experiences we’ve gained, but also the bold leadership we have today. Read the full speech

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Primary Care First: Foster Independence, Reward Outcomes

Post author By Jim Nonneman
Post date April 23, 2019

Apr 22, 2019 | cms.gov

Primary Care First is a set of voluntary five-year payment model options that reward value and quality by offering innovative payment model structures to support delivery of advanced primary care. In response to input from primary care clinician stakeholders, Primary Care First is based on the underlying principles of the existing CPC+ model design: prioritizing the doctor-patient relationship; enhancing care for patients with complex chronic needs and high need, seriously ill patients, reducing administrative burden, and focusing financial rewards on improved health outcomes.

Why develop a new model based on the underlying principles of the CPC+ model?
Primary care is central to a high-functioning healthcare system and thus, there is an urgent need to preserve and strengthen primary care as well as a need for support of serious illness care services for Medicare beneficiaries.

Primary Care First addresses these needs by creating a seamless continuum of care and accommodates a continuum of interested providers. The payment options test whether delivery of advanced primary care can reduce total cost of care, accommodating practices at multiple stages of readiness to assume accountability for patient outcomes. Primary Care First will focus on advanced primary care practices ready to assume financial risk in exchange for reduced administrative burdens and performance-based payments.

Thorough a second payment model option, Primary Care First also encourages advanced primary care practices, including providers whose clinicians are enrolled in Medicare who typically provide hospice or palliative care services, to take responsibility for high need, seriously ill beneficiaries who currently lack a primary care practitioner and/or effective care coordination—population groups referred to under the model as the Seriously Ill Population or SIP.

How does Primary Care First transform the health care system?

Primary Care First reflects a regionally-based, multi-payer approach to care delivery and payment. Primary Care First fosters practitioner independence by increasing flexibility for primary care, providing participating practitioners with the freedom to innovate their care delivery approach based on their unique patient population and resources. Primary Care First rewards participants with additional revenue for taking on limited risk based on easily understood, actionable outcomes.

What are the model’s goals and how will the model achieve these goals?
Primary Care First aims to improve quality, improve patient experience of care, and reduce expenditures. The model will achieve these aims by increasing patient access to advanced primary care services, and has elements specifically designed to support practices caring for patients with complex chronic needs or serious illness. The specific approaches to care delivery will be determined by practice priorities. Practices will be incentivized to deliver patient-centered care that reduces acute hospital utilization. Primary Care First is oriented around comprehensive primary care functions: (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and (5) planned care and population health.

Primary Care First aims to be transparent, simple, and hold practitioners accountable by:

Providing payment to practices through a simple payment structure, including:

a payment mechanism that allows care to be driven by clinicians rather than administrative requirements and revenue cycle management;
a population-based payment to provide more flexibility in the provision of patient care along with a flat primary care visit fee; and
a performance based adjustment providing an upside of up to 50% of revenue as well as a small downside (10% of revenue) incentive to reduce costs and improve quality, assessed and paid quarterly.

Providing practice participants with performance transparency, through practitioner-identifiable information on their own and other practice participants’ performance to enable and motivate continuous improvement.

Primary Care First provides the tools and incentives for practices to provide comprehensive and continuous care, with a goal of reducing patients’ complications and overutilization of higher cost settings, leading to higher quality of care and reduced spending.

How will beneficiaries and their families benefit from Primary Care First?

Primary Care First prioritizes patients by emphasizing the doctor-patient relationship. The model aims to improve the experience for beneficiaries by reducing administrative burdens so practitioners can spend more time with patients. The Centers for Medicare & Medicaid Services (CMS) will prioritize patient choice in the assignment of Medicare beneficiaries to Primary Care First practices. Read the full press release

HCCI in the News Press Releases

HCCI Launches Nationwide Network for Home-Based Primary Care Education

Post author By Bob Braschel
Post date August 1, 2017
No Comments on HCCI Launches Nationwide Network for Home-Based Primary Care Education

August 1, 2017

HCCI Centers of Excellence, which include eight prestigious medical institutions, to leverage first and only comprehensive curriculum in the U.S. to help meet the growing need for home-based primary care professionals.

Read the full article.