CMS issues an updated Advance Notice document each year, officially titled for 2024 “Advance Notice of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies”.

In case you missed the news: The Amazon acquisition of One Medical officially closed on February 22. In one of our recent newsletters, we talked about Amazon’s entrance into the medical world through Amazon Clinic–which provides quick treatments for common conditions in 20 states.

The Centers for Medicare & Medicaid Services have advanced value based care significantly in the last several years, and in a somewhat expected, yet bold move in October 2021, specifically said that they expect all traditional Medicare beneficiaries to be treated by a provider in a value-based care model by 2030. CMS rarely uses such superlative terms (all traditional Medicare beneficiaries), and the Centers for Medicare & Medicaid Services Innovation Center (CMMI) has five stated strategic objectives to achieve this massive undertaking.

Primary Care Providers (PCP) are problem solvers trained to learn as much as they can about the entire human body. As soon as the patient begins to describe their concern, the PCP is processing the information and evaluating possible solutions or treatments. It is often difficult to determine how much time is needed for a visit because they are trained to not just look at a single problem, but the whole person. Value-based care and mandatory quality measures (or risk losing money) have made the primary care visit even more complex. If a provider runs late, patients become irritated and upset but expect the provider to give them the amount of time needed for whatever “oh by the ways” they mention even if it wasn’t included in the reason for visit.

Work smarter not harder is a phrase often heard in many settings, not just healthcare but what does that mean in the primary care world? How can we work smarter not harder when there is so much work to be done?  Change in any form can be difficult and scary, especially when it involves new technology.  Finding the right solution and gaining buy-in from providers and team members can be the most difficult part of this process even if the solution will make their job easier.  The key is to engage the affected team members early on, share the vision, acknowledge the loss of the old way, and give them opportunities to participate in the process.

Primary care, and the leaders, physicians, clinicians, and support team within those primary care offices, are truly at the heart of making healthcare better. As we close out 2022 and enter 2023, there is no better time to focus on something that’s often overlooked in the business of primary care - you and your intentions.

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.

Over the past 40 years, we've seen a large shift in primary care and the United States healthcare system. Unfortunately, the changes have resulted in a very broken system, and we now more than ever see the need to correct the flaws.

The National Committee for Quality Assurance (NCQA) has developed a list of metrics and measures they consider pertinent to the assessment of quality in the delivery of healthcare based on access, availability, effectiveness, and outcomes