6 minute read
BCBS Announces Enhanced Resources for Independent Family Physicians
PRACTICE MANAGEMENT
By Brent Hazelett, MPA, CAE NCAFP Chief Operating Officer
Managing a practice in North Carolina got significantly more challenging on July 1st with the long-delayed transition to Medicaid Managed Care. Nowhere is this more evident than for those practicing independently. Fortunately, over the past few years several new organizations and initiatives have been developed specifically for small practices (Community Care Physicians Network, Aledade, and others to name a few).
Recently, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced a new investment that will support independent physicians and help them strengthen their practices. Established as a joint venture, the new entity will provide services to enable physicians to focus more on high-quality, cost-effective patient care while also offering practices the ability to grow more sustainably as value-based care expands. It is no secret that Blue Cross NC is evolving quickly towards value-based payment models and this latest announcement underscores this commitment. According to Blue Cross NC, the new organization has been developed in collaboration with Deerfield Management Company, a health care investment firm with deep experience strengthening physician practices. The joint venture is the next phase of Blue Cross NC’s ongoing collaboration with providers to make health care better, simpler, and more affordable. The venture will leverage Deerfield’s research and operational capabilities, and its extensive experience investing across all sectors of health care at every stage of development – including key investments and relationships in North Carolina.
“Independent physicians in North Carolina have an especially difficult burden when it comes to managing their practices without the resources and scale that come with being part of a larger organization,” said Dr. Tunde Sotunde, Blue Cross NC president and CEO. “We want to empower independent physicians – especially primary care – by offering a new level of support to help them lead their practices in a time of great change in health care. This new organization will fill a void for practices that are independently owned and will help them thrive.”
The new venture has been created with the goal to:
• Provide infrastructure and support services to reduce administrative burdens and alleviate physician burnout;
• Equip physicians with integrated technology solutions to monitor, manage and coordinate patient care effectively;
• Share data and insights alongside value-added ser-
See 'BCBSNC' on Back Cover
Confirm Contact Info for 2022 Dues Invoices
It might seem early to be thinking about dues for 2022, but invoices are being prepped now for online payment to begin in late September. Mailed invoices will be sent to primary addresses in October. Payment deadline is January 1, 2022. As a result, it is imperative that your contact information is up to date. We encourage all members to take a moment to verify all contact information contained in your member record. To do so, please visit aafp.org/ welcomecenter and log into your account. Remember, your username is your email address associated with your member record. You may also call the AAFP at 1-800-274-2237 between 9:00 a.m. – 6:30 p.m. M-F.
ADOLESCENT IMMUNIZATION
By: Leonard Friedland, MD, Vice President, Scientific Affairs and Public Health, GSK Vaccines, North America
A new claims analysis commissioned by GSK and conducted by Avalere Health, a healthcare research firm, showed a sustained drop in immunization rates for recommended vaccines among adolescents (aged 7-18) and adults (19+) throughout the pandemic in 2020. The study examined claims for CDC-recommended vaccines across commercial, managed Medicaid, Medicare Advantage and Medicare fee-for-service Part B from January through November 2020 compared to the same time period in 2019.
During the COVID-19 pandemic, adolescent and adult immunizations sharply declined, increasing the risk for preventable diseases, and further straining an overworked health care system. The study found:
Adolescents and adults potentially missed over 26 million doses of recommended vaccines in 2020. This includes 8.8 million missed adolescent vaccine doses and 17.2 million missed adult vaccine doses.
Vaccine claims remain well below 2019 levels. Total non-influenza vaccine claims submissions were between 13-35% (adolescents) and 1740% (adults) lower than the same period in 2019.
Despite warnings of a potential “twindemic,” influenza immunization rates were lower in 2020 than in 2019. Early gains in influenza vaccination claims lagged as the season progressed. Influenza vaccination claims from August-September of the 2020-21 season initially exceeded the same months of the 2019-20 season, suggesting early heightened awareness of respiratory disease in 2020; however, those surges levelled off by October and then fell in November.
A GROWING VACCINE GAP
Even before the COVID-19 pandemic, immunizations were under-utilized for adults and adolescents and in underserved populations;i the pandemic has compounded this problem. Herd immunity is important to control spread of an infectious disease within a population, and even small drops in immunization rates can lead to a resurgence of disease as was demonstrated by the 2019 measles outbreaks in the US.
History shows us what happens when individuals go unprotected against infectious and debilitating disease. For example, despite the availability of a vaccine since 1995, from 2016 through May 2021, 31 states had declared hepatitis A outbreaks, reporting 39,488 cases to the CDC.ii In 2014-15, 15 years after the World Health Organization declared measles eliminated from the US, a measles outbreak linked to exposures at the Disney theme parks in California sickened 147 people, most of them unvaccinated. In 2019, the CDC tallied 1,282 measles cases in 31 states.iii iv From 2011 through March 2019, meningitis B vaccination (recommended for teens and young adults aged 16-23) caused all US college meningococcal outbreaks, which involved 13 campuses, 50 cases, and 2 deaths among an at-risk population of approximately 253,000 students. Even though MenB vaccination has been available since 2014, recent
See 'Immunization' on Back Cover
vices to identify and address opportunities to improve care;
• Offer flexible options to help physicians structure the management and ownership of their practices.
“Offering new resources to independent physician practices is the ideal next step in our collaborations with health care providers to improve quality and reduce costs for our members and for all North Carolinians,” said Dr. Von Nguyen, senior vice president and chief medical officer at Blue Cross NC. “Independent physicians typically have hundreds, if not thousands, of patients to care for, and they have a business to run. If we provide additional support to help them meet these demands, we can have a positive impact on health outcomes while doing more to address rising health care costs.” Greg Griggs, NCAFP Executive Vice President commented, “The Academy is committed to working with payers to find creative solutions to reduce administrative burdens and increase payment to our members. For years Blue Cross NC has been willing to have meaningful conversations with the Academy about how they can better serve our members in an increasingly challenging climate for primary care. We are pleased this latest initiative is particularly focused on providing resources to the most challenged family physicians in North Carolina and look forward to providing input into the final details of this effort.”
Stay tuned for more details about this new program and how it might help you and your practice.
'IMMUNIZATIONS,' continued from p27
CDC data show that still, only about 1 in 5 17-year-olds in the US received at least one dose of MenB vaccination.
CATCHING-UP ON ROUTINE VACCINES
The CDC recently issued guidance that COVID-19 vaccines and other vaccines can be administered to people on the same day, making “catch-up” easier for adolescent and adult patients who may have missed vaccines.
Family Medicine has a critical role to play in closing the gap on routine vaccination in the United States, especially among teens and adults. Ensuring that your patients are up-todate on CDC-recommended vaccines is one of the most important things you can do to keep individuals and communities healthy in the months to come. Learn more about the Avalere study and methodology at: https://avalere.com/insights/updated-analysis-finds-sustaineddrop-in-routine-vaccines-through-2020
SOURCES i https://www.hhs.gov/sites/default/files/ HHS-Vaccines-Report.pdf
ii https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm
iii https://blogs.cdc.gov/publichealthmatters/2015/12/year-in-review-measles-linked-to-disneyland/
iv https://www.cdc.gov/measles/cases-outbreaks.html
www.ncafp.com Raleigh, North Carolina 27607 2501 Blue Ridge Road, Suite 120,
Permit No. 592 Pontiac, Illinois
PAID
US Postage Non-Profit Org.
