Hello CHPA Community,
We are members of the National Association of Accountable Care Organizations (NAACOS). They had a conference recently and invited Christopher Koller, President of the Milbank Memorial Fund, to offer one of the plenary session addresses. The Milbank Memorial Fund has been around for more than 100 years as an operating foundation that improves population health and health equity by connecting leaders with experience and sound evidence.
Mr. Koller’s presentation was about how primary care is the lifeblood of healthcare. It was a compelling affirmation of the essential work our members do for people every day. He made a strong case for why primary care needs to be strengthened and value-based care needs to be advanced through Accountable Care Organizations (ACOs) like CHPA. For example, ACOs comprised of 75% primary care clinicians saw $281 per capita in net savings compared to $149 per capita in net savings for ACOs with fewer primary care clinicians. This underscores how important primary care is to the success of programs such as the Medicare Shared Savings Program (MSSP).
There are significant threats to primary care as it exists today and these market forces oppose what our members stand for. Private equity and corporations love primary care but not for the same reasons we do. In this year alone, CVS Health announced it is partnering with Carbon Health, a digital health platform, to invest $100 million to pilot primary care practices in CVS retail stores. $10.6 billion more dollars was spent by CVS to acquire Oak Street Health. Molina Healthcare is purchasing Bright Health Group’s California MA plan for $600 million, which means they paid $4,800 for each of their 125,000 enrollees. Projections are that 30% of the U.S. primary care market will be owned by non-traditional players by 2030. When interests in financial gain surpass quality outcomes, patients lose.
As we have experienced in Colorado, workforce shortages are a major contributor to the challenge of maintaining a strong primary care system. It is estimated that only 1 in 5 physicians are entering primary care as they opt for specialty care instead. His organization reports primary care spending decreased from 2010 to 2020 and access is getting harder as a result. 27% of adults and 10% of children are without a usual source of care.
Mr. Koller made a plea to do whatever we can to cultivate primary care, grow with attributed lives and contract alignment, take downside risk, seek independence, and persist. He put forth the following five objectives for achieving high-quality primary care in our healthcare delivery system.
- Payment: Pay for primary care teams to care for people, not doctors to deliver services
- Access: Ensure that high quality primary care is available to every individual and family in every community
- Workforce: Train primary care teams where people live and work
- Digital Health: Design technology that serves the patient, family, and inter-professional care team
- Accountability: Ensure that high quality primary care is implemented in the US
We cannot thank you enough for all that you do to make our healthcare system work better and lead the way as an example of what works. Let us know how CHPA can support you and your care teams.
Be well,
Ben Wiederholt, Interim CEO
