Governor's Task Force on Primary Care Takes Quick Action to Aid Virginia's Primary Care Clinicians
Over 750,000 pieces of PPE sent to front line primary care clinicians.
By VCHI Staff
Richmond, Virginia, November 25, 2020 – Today the Virginia Center for Health Innovation (VCHI) released an update on the work of the Governor’s Task Force on Primary Care. The Task Force was formed in July as a response to the increasing strain on primary care clinicians due to the COVID pandemic. While one of the aims of the Task Force is to define long term payment models that better support patient access to primary care while ensuring practice viability, the group identified a number of short-term supports that it is recommending for immediate action.
One of the first needs the group identified was access to personal protective equipment (PPE) for primary care clinicians. Shortages of PPE, especially N95 masks, have been widely publicized. Unlike hospitals with established supply chains, primary care practices have struggled to identify vetted vendors and meet significant minimum order requirements. Primary care clinicians are the front line – often doing a significant amount of COVID testing – so access to PPE is critical. In order to better understand the need, the Task Force partnered with Virginia’s primary care professional associations to survey primary care clinicians across the commonwealth regarding their access to PPE. The survey results showed that 83% of practices reported difficulty procuring PPE. The PPE needs were not limited to N95 masks – the survey showed a wide range of equipment needs. After sharing the results of this survey with members of the Governor’s administration, including Task Force member Secretary of Health and Human Resources Daniel Carey, MD, MHCM, VCHI was able to secure a one-time allocation of PPE for primary care clinicians across Virginia from the Virginia Department of Emergency Management. “Across Virginia, primary care practices have had to lay off staff and even close due to impacts of the COVID-19 pandemic,” said Secretary of Health and Human Resources Daniel Carey, MD, MHCM. “Through the hard work and expertise of this task force, we have been able to help get Virginia’s primary care teams the resources they need to continue safely treating their patients. I am grateful for the partnership with the Virginia Center for Health Innovation (VCHI) and their assistance in these efforts.”
Thanks to a collaborative effort that included logistical support from VCHI staff; packing help from faculty and students from the University of Lynchburg’s Physician Assistant program; shipping boxes donated by The Supply Room; and special shipping rates from UPS; nearly 750,000 pieces of PPE were distributed. Jeremy Welsh, PA-C, JD, DHSc, Dean of the School of PA Medicine at the University of Lynchburg and a member of the Task Force said, “the University of Lynchburg and the School of PA Medicine was proud to contribute to the work of distributing PPE for the Governor’s Task Force. Our students and faculty are committed to servant leadership and are honored to contribute to clinician health and safety throughout the commonwealth of Virginia.” After the initial round of orders were distributed, remaining supplies were sent to Virginia’s free clinics and federally qualified health centers.
Rhonda Muchmore RN, MSN, a nursing supervisor with Virginia Pediatric & Adolescent Center and a recipient of the supplies, expressed her gratitude. “We were very grateful to receive supplies of masks, gowns and gloves from the Governor’s Task Force on Primary Care”, said Ms. Muchmore. “Since the start of the COVID pandemic we have struggled to obtain necessary PPE to keep our staff and patients safe from any possible transmission of COVID. We have been limited to the very bare minimum in our allocations of needed supplies, so getting a shipment like this was extra appreciated. Receiving the N95 masks is especially important as we have not been able to order any of these since the pandemic first started. To get what we considered a large amount was very much appreciated as we are seeing an increase in cases within our pediatric population.”
In addition to the physical distribution of PPE, the Task Force focused on short-term payment reform solutions that could aid primary care. These recommendations are as follows:
- Virginia’s health plans voluntarily implement one or more of the following options for their commercially fully-insured and willing self-insured customers:
- extend the telehealth provisions of HB 5046 (Adams) and the identical SB 5080 (Barker); and/or
- reimburse CPT code 99072 (for PPE) at a rate not below $6.57 for the later of the duration of the Public Health Emergency or December 31, 2021; and/or
- pay each primary care provider (PCP) $2 per member per month (PMPM) for patients attributed to them by current methodologies, starting as soon as feasible and for one year or the duration of the Public Health Emergency, whichever is longer, IF the PCP agrees to a contract wherein, within one year of the end of the Public Health Emergency, the PMPM amount or other non-Fee For Service (FFS) payment will depend upon performance on quality, patient experience, and total cost of care metrics; and/or
- implement an enhanced FFS payment plan that would apply to all PCPs and pay all FFS evaluation and management CPT codes at 110% of current rates, starting as soon as possible and continuing for one year or the duration of the Public Health Emergency, whichever is longer.
- Virginia’s health plans, with assistance from the Virginia Association of Health Plans, submit a report to the Governor’s Task Force on Primary Care no later than February 1, 2021 detailing the specific financial support each provided to Virginia primary care clinicians to address pandemic issues from March 1, 2020 through December 31, 2020. This data will be utilized to better inform long-term task-force recommendations. This report would include, but is not limited to data pertaining to increases in FFS rates, PMPM, PPE CPT code reimbursement, and expansions in telehealth coverage.
- A recommendation that the Department of Medical Assistance Services (DMAS) submit a report to the Governor’s Task Force on Primary Care no later than March 1, 2021 detailing the anticipated impacts (financial, logistical, access) of a) paying for Medicaid primary care services at parity with Medicare and b) of implementing a PMPM model for Virginia Medicaid.
The work of the Task Force now turns to long-term payment reform and will continue to meet monthly through July 2021.
The Task Force Members are:
- Sandy Chung, MD, Co-Chair | Fairfax Pediatrics Associates, Immediate Past President- AAP, Virginia Chapter, Fairfax
- Jeff Ricketts, Co-Chair | President, Anthem Virginia, Richmond
- Jill Age | EVP Towne Insurance, a subsidiary of Towne Bank, also Past President Virginia Association of Health Underwriters, Tidewater
- Delegate Lashrecse Aird | Democrat, 63rd District, Chesterfield/Petersburg
- Julie Bilodeau, MBA | CEO, CrossOver Healthcare Ministry, Richmond
- John Brady, MD | TPMG, Newport News, Chair – American Board of Family Medicine
- Michael Bucci | Market President, Aetna, Maryland, DC, and Virginia
- Secretary Daniel Carey, MD | Health and Human Resources Secretary, Commonwealth of Virginia, Richmond
- Michael Cassidy, MPP | President and CEO, Commonwealth Institute for Fiscal Analysis, Richmond
- Colette Chichester | VP, CareFirst, DC, and President, Virginia Association of Health Plans
- Senator Siobhan Dunnavant, MD | Republican, District 12; OBGYN, Henrico
- Emily Elliott | Director, Virginia Department of Human Resource Management, Richmond
- Wina Giddens | Director, Benefits & HRIS, Port of Virginia, Tidewater
- HoChong Gilles, NP | McGuire Department of Veterans Affairs Medical Center, Chesterfield, Immediate Past-President, Virginia Council of Nurse Practitioners
- Neeta Goel, MD | Chief Medical Officer, Ambulatory Services, Inova Health System Fairfax
- Jill A. Hanken, Esq. | Director of the Center for Healthy Communities and ENROLLVirginia!; Virginia Poverty Law Center, Richmond
- Bryan Haynes | CEO, Southwest Virginia Community Health System, Saltville
- Stuart Henochowicz, MD, MBA, FACP | Internal Medicine and Allergy Associates; Governor ACP, Virginia Chapter, Burke
- Cornel Hubbard, JD, CCEP | VP and General Manager, Magellan of Virginia, Richmond
- Anthony Keck | EVP for System Innovation and Chief Population Health Officer, Ballad and VCHI Chair, Bristol
- Jesus Lizarzaburu, MD | Legislative Chair, Virginia Academy of Family Physicians, Yorktown
- Thomas Lundquist, MD | SVP and CMO, Optima, Tidewater
- Ellen Montz, PhD | Chief Deputy and Chief Health Economist, DMAS
- Katherine Neuhausen, MD, MPH | Senior Medical Director, Community and State, UnitedHealthcare, Richmond
- Deborah D. Oswalt | Executive Director, Virginia Health Care Foundation
- Nicole Riley | Virginia State Director, National Federation of Independent Businesses, Richmond
- Christina Stasiuk, DO | Mid-Atlantic Market Medical Executive, Cigna, Philadelphia
- Meredith Touchstone | Director, Benefits, Carmax, Richmond
- Cameron Webb, MD, JD | Internal Medicine, Director of Health Policy and Equity, University of Virginia
- Jeremy Welsh, PA-C, JD, DHSc | Dean and Chair, School of PA Medicine, University of Lynchburg; President Virginia Academy of Physician Assistants
- Lisa Woods | Senior Director, Strategy and Design, US Benefits, Walmart, Arkansas
About the Virginia Center for Health Innovation
Incorporated in January 2012 following a recommendation from Gov. Robert McDonnell’s Virginia Health Reform Initiative, the Virginia Center for Health Innovation (VCHI) seeks to facilitate innovation by convening key stakeholders and securing the resources to accelerate value-driven models of wellness and health care throughout Virginia. VCHI’s work is focused on achieving three aims: reducing low-value health care, increasing high-value health care, and ensuring Virginia has the infrastructure in place to measure and reward value in health care. Among its many innovative projects, the most notable for their alignment with this initiative are the Virginia Health Value Dashboard and the Virginia Scorecards on Payment Reform.
Images below courtesy of Dr. Jeremy Welsh, University of Lynchburg