If you are a primary care practice, you’re most likely aware of the CMS directive to have all Medicare fee-for-service beneficiaries in an arrangement that includes accountability for quality and total cost of care by 2030. You’ve also most likely been approached within the last few weeks about joining an Accountable Care Organization (ACO), likely by multiple different groups, or you’ve done research and heard about ACOs recently. With Phase 1 of the ACO application period of May 18, 2023 through June 15, 2023 and Phase 2 July 11, 2023 through August 1, 2023, being aware of the deadlines is important, but even more important is being prepared to succeed in an ACO, and making the decision to even join one for the 2024 performance year.

If you are a primary care practice, you’ve likely been approached within the last few weeks about joining an Accountable Care Organization (ACO), possibly by multiple different groups. The reason for this flurry of activity is Phase 1 of the ACO application program goes from May 18 to June 15, 2023 and the final phase to add TINs to an ACO is July 11 to August 1, 2023. If you’re not already in an ACO, you’ll need to make some important decisions about whether or not to join an ACO for 2024, and which ACO to join. 

Health equity has become a topic of increased awareness and interest in the last several years, and CMS has most assuredly taken notice. Before you think that this is not my practice, not my concern, and not something I have to worry about, it’s best to be informed of what health equity is, what CMS is doing about it, and why health equity matters at your practice.

The CMS Innovation Center (CMMI) has produced many directives recently, many of which deal with the future of value based care. A 2021 strategy statement summarized the vision of CMMI, with these two statements showing how to measure progress.

The Dictionary defines leadership as “the action of leading a group of people or an organization”. There are a variety of interpretations of what it means to be a leader but I would like to expand on this and create a definition of the word specific to the primary care setting. Leadership in primary care is “the action of inspiring, encouraging, and empowering a team of people to work together to provide high quality care to their patients resulting in positive outcomes and strong interpersonal relationships”.

The patients at your practice, your staff, the physicians, vendors and other support partners - these are all critical to your success. But when it comes to self care, the most important person at your practice is … you!

The Great Resignation is a term with which we as society are all too familiar, and physician practices are definitely not exempt from the sting of The Great Resignation. Throughout the pandemic, healthcare workers (among others) were heralded as heroes, with many public displays of support and care as we all banded together to get through something none of us have ever seen before. Doctors, nurses, and practice staff were showered with support and kindness, sent letters and cards, and were generally appreciated.

Imagine this.

You’re in a new city for a trip, and have checked in to your hotel for the stay. It’s close to dinner time, and you are ready to go out and eat. What do you do? If you’re like most people, you’ll open up one of many websites or apps, such as Google, Yelp, Facebook, or others, and search for dining options near you. You’ll likely look at which ones are the closest options, then see what type of restaurant strikes you.

The Extreme and Uncontrollable Circumstances (EUC) adjustment from CMS, also known as Covid protection, has now expired, which means that the overall star ratings for health plans will not be adjusted to account for Covid. There was an overall decline in year over year star ratings over the last two years, with the national average star rating declining from 4.37 in calendar year 2021 to 4.15 in 2022, a decline of 0.22.

Call-outs, resignations, and limited staffing resources make it challenging to keep up with the day to day requirements of a primary care practice. While many corporations are transitioning to remote or hybrid work and are increasing compensation to remain competitive, it is difficult to make these changes in a field where in person contact is necessary. Telemedicine is certainly a trend here to stay, but most visits still require an in-person appointment so the provider can listen to the patient’s heart, lungs, and perform tests that cannot be done from home.