WITH STRONG BIPARTISAN SUPPORT, THE VIRGINIA TASK FORCE ON PRIMARY CARE SECURES $82M PAYMENT INCREASE

WITH STRONG BIPARTISAN SUPPORT, THE VIRGINIA TASK FORCE ON PRIMARY CARE SECURES $82M PAYMENT INCREASE FOR CLINICIANS AND STARTS THIRD YEAR OF WORK

By VCHI Staff

Richmond, Virginia July 7, 2022 –Today the Virginia Center for Health Innovation (VCHI) released an update on the accomplishments of the Virginia Task Force on Primary Care. The task force was formed in July 2020 both as a response to the immense strain on primary care clinicians from the COVID pandemic and a need to better ensure the long-term sustainability of and access to primary care services for the Commonwealth’s patients.

One of the first needs the group identified was access to personal protective equipment (PPE) for primary care clinicians and their office staff, a necessity if practices were to remain open during the pandemic.  Unlike hospitals with established supply chains, many primary care practices struggled to identify vetted vendors and meet significant minimum order requirements. In order to better understand the need and make the case for state action, the task force partnered with Virginia’s primary care professional associations to survey primary care clinicians across the Commonwealth. The survey showed that 83% of practices reported significant difficulty procuring PPE in the summer of 2020. After sharing these results with members of the Northam Administration, VCHI was able to secure and distribute a one-time allocation of 750,000 pieces of PPE, thereby supporting every requesting primary care practice.

The task force then acted to advance payment reform solutions that would improve the long-term viability of primary care in Virginia. After showing legislators that Medicaid primary care services are reimbursed at a rate significantly lower than either the commercial or Medicare payment rates, a 10 percent increase in payment gained strong bipartisan support. On June 21, 2022, Governor Youngkin signed the FY’23-24 state budget that includes $82 Million in new Medicaid funding for primary care. The budget specifically states: “Effective July 1, 2022, the Department of Medical Assistance Services shall have the authority to increase Medicaid Title XIX and CHIP Title XXI reimbursement rates for physician primary care services, excluding those provided in emergency departments, to 80 percent of the federal FY 2021 Medicare equivalent as calculated by the department and consistent with the appropriation available for this purpose. The department shall have the authority to implement these changes prior to the completion of any regulatory process to effect such changes.”

In a further show of support, the budget also includes funding for the continuation of the task force for two additional years. The task force will utilize this funding to support  Virginia’s primary care assessment infrastructure – with deliverables including primary care and total cost of care spend reports, a bidirectional tool to enhance immunization data sharing, a primary care performance dashboard, a primary care measures pilot, a plan to enhance primary care infrastructure support and connectivity with public health, a plan to address clinical retention challenges, and a payment reform model for Medicaid that includes new accountability metrics.

“We look forward to the task force working closely with the Youngkin administration, particularly with the Virginia Departments of Health and Medical Assistance Services, to advance system change by reviewing data and identifying key drivers of data variation” said Virginia’s Secretary of Health and Human Resources, John Littel. “We believe this data is necessary to advancing better value in the primary care services we offer all Virginians.”

Lead staff for the task force, VCHI’s President and CEO, Beth Bortz, attributes its strong early success to the amazing spirit of collaboration that was fostered across the clinician, health plan, employer, patient advocate, and state government task force members. “We purposely chose to have a leading primary care voice (Dr. Sandy Chung, President-elect of the American Academy of Pediatrics) paired with a leading health plan voice (Jeff Ricketts, President of Anthem Virginia) as our co-chairs. They worked in tandem with Virginia’s Secretaries of HHR (first Daniel Carey, MD and then John Littel) as well as the only physician member of the Virginia General Assembly (Siobhan Dunnavant, MD) to build consensus and enable swift progress. The task force members came to the table ready to compromise and deliver results. We are delighted to share that they did just that and look forward to the year of work ahead to further strengthen Virginia’s primary care provision.”

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.

For more information visit: www.vahealthinnovation.org and follow on Twitter, Facebook and LinkedIn.

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