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Practice Transformation

As of April 5, health care organizations must provide patients with free, full and immediate electronic access to their doctors’ clinical notes as well as test results and pathology and imaging reports. Organizations must provide access via patient portals to the following types of notes: consultations, discharge summaries, histories, physical examination findings, imaging narratives, laboratory and pathology report narratives and procedure and progress notes. Noncompliant organizations will eventually face fines for information blocking. (Medscape Medical News)
Our health care system isn’t meeting the needs of patients with mental health and substance use problems; primary care integration can help address this, according to presenters at a Bipartisan Policy Center forum. The event marked the release of a new report, “Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration.” Integrating behavioral and mental health with primary care and making pandemic-related flexibilities in telehealth permanent can increase access to care. The report includes several recommendations, including creating quality and service standards for integrated care and a capitated, risk-adjusted model for primary care. (MedPage TodayBPC forum)
“According to panelists at a Bipartisan Policy Center (BPC) and GTMRx Institute [virtual event], primary care physicians (PCPs) can be key players in the movement to building confidence in the COVID-19 vaccine,
Since last November, CVS Caremark has surveyed thousands of Americans about their intentions regarding the COVID vaccine, explained Sree Chaguturu, MD, CVS Caremark chief medical officer, noting that 45% combined said that they definitely would, or definitely would not, get the vaccine, while 55% considered themselves to be in the ‘movable middle.’
Donald Berwick, MD, MPP, former CMS administrator and founder of the Institute for Healthcare Improvement, emphasized that ‘trust is everything… trust in science … trust in accumulated experience, and trust in the helpers.’
Bill Frist, MD, former Senate majority leader and a senior BPC fellow, noted that the largest divide among those who are vaccine hesitant, and those who aren’t, is a political one. A recent Kaiser Family Foundation poll found Republicans and white evangelical Christians are the most likely to say that they definitely will not get the vaccine. Frist called for removing the ‘political undertones’ in conversations around vaccines in order to increase trust.” (MedPage Today)
Evidence & Innovation
A new risk-stratification tool based on machine learning has shown early promise in identifying high-risk patient needs and boosting clinician engagement with care planning. Oak Street Health—which cares for the underserved—found that the risk-stratification tool outperformed previous backward-looking approaches in identifying high-risk patients, according to a NEJM Catalyst paper. “Early feedback from Oak Street Health’s primary care providers (physicians and nurse practitioners) and nonproviders (social workers) suggests that the display of top risk factors based on model predictions created a broadly interpretable and actionable risk stratification tool in caring for the highest-risk patients.” (NEJM Catalyst)
A stepped collaborative care method, which helped injured patients with post-traumatic stress disorder transition from hospital inpatient to outpatient and community settings, improved symptoms after six months. The Trauma Survivors Outcomes and Support collaborative care intervention included proactive injury case management that assisted patients transitioning from hospital inpatient to outpatient and community settings. The intervention also integrated evidence-based pharmacotherapy and psychotherapeutic elements targeting PTSD symptoms and comorbidity. (JAMA Surgery)
MedPAC unanimously voted to recommend covering all preventive vaccines for Part B beneficiaries with no cost sharing. The change would likely improve Medicare beneficiaries’ access to care since more of them have Part B coverage than Part D coverage—and more types of providers would be able to administer vaccines, Modern Healthcare reports. MedPAC also recommends paying providers 103% of vaccine wholesale acquisition costs and making vaccine manufacturers report average sales price data to CMS for analysis. (Modern Healthcare*; InsideHealthPolicy)

Policy Solutions

Pharmacy chains, including CVS Health, Walgreens and Rite Aid, are playing a large role in vaccine distribution. Providing vaccinations isn’t much of a moneymaker, but the data they collect may be quite valuable, Politico reports. Some retailers, including Walgreens and Walmart, require people to create online user accounts before they can search for vaccine appointments. Some privacy attorneys say pharmacies have wide latitude to collect and use customer data, but watchdog groups, consumer advocates and others have expressed concern about how chains will use that data and are calling for restrictions. (Politico)
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In Case You Missed It!

The Get the Medications Right™ Institute convened leaders at April 6’s BPC event to inform the public’s views on vaccination safety, effectiveness and trust. During the event, GTMRx released a new report, Background and Resources to Build Vaccine Confidence in the Medical Neighborhood, to serve as a “level-setting” tool for the new GTMRx National Task Force: Building Vaccine Confidence in the Medical Neighborhood as they begin crafting recommendations helpful to overcoming barriers and build vaccine confidence in local communities today and in the future. Read the report here.
On April 6, the Bipartisan Poicy Center and GTMRx Institute convened a panel discussion to offer guidance on building vaccine confidence and engaging the medical neighborhood. Vaccinating Americans is critical to preventing severe illness or death from COVID-19 and ultimately stopping the pandemic. It is also essential in getting people back to work, to play and to living. To achieve widespread vaccination, engagement of the medical neighborhood is fundamental when implementing community programs designed to effectively build vaccine confidence. While we have seen encouraging vaccination rates, urgent action is necessary to reach herd immunity which experts estimate would require anywhere from 70% to 90% of the U.S. population be fully vaccinated. The reasons people are skeptical about taking the coronavirus vaccine are complex. Building vaccine confidence requires proactive and thoughtful public awareness, education and engagement of a variety of local stakeholders including community members. Watch the recording here.
Over the last decade, there has been progress in defining and outlining CMM as part of a team-based care through research and descriptive reports. However, there are still gaps that exist which would benefit from added research focus moving forward. Based on a review of the current literature on the implementation and impact of CMM, this report outlines the existing gap areas and offers recommendations on approaches to close those gaps.
Developed by the Evidence-Based Resources Subgroup of the Practice and Care Delivery Transformation Workgroup.
Read the document here.
On April 6 from 2:00-3:00p EST, Julia Skapik, MD, MPH, medical director at National Association of Community Health Centers (NACHC) spoke to the Telehealth Delivery of CMM Subgroup of the GTMRx Payment and Policy Solutions Workgroup. Dr. Skapik informed the subgroup about guidance on IT requirements and documentation of services in telehealth, resources and information on developing guidance for documentation of CMM via telehealth and what ideal changes of rules and regulations that would facilitate CMM via telehealth as a standard routine part of patient care would like look.
As a leader in the health care field, your opinion on issues facing the health care industry today is crucial.
Because the GTMRx Institute is committed to keeping a pulse on what matters, we’ve developed a quick two?-minute survey to gather feedback on issues in health care and pharmaceutical care management.
We’d be grateful for your participation. Please respond by no later than April 21. Take the survey here.
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