The America's Physician Groups (APG) annual conference was back in San Diego after a more than two-year break. Bobby von Bremen, Vice President of Sales & Marketing at RCxRules, was in attendance and shares his takeaways in this blog post.
The attendees I spoke to were energized to be back at an in-person event (following COVID protocols like masking and social distancing, of course). It was great to meet face-to-face again and to benefit from talks given by the big names APG always attracts. I noticed two themes throughout the conference that I think will set the tone for the year to come. The first is APG’s continued advocacy for value-based care within the physician group market, and the second is the increasing importance of health equity in value-based care.
Don Crane, APG’s CEO, kicked off the meeting and quickly transitioned to an issue that was clearly top of mind—Don Berwick (MD, former CMS administrator) and Rick Gilfillan’s (MD, former head of CMMI) editorial in Health Affairs on the “Medicare Gold Rush” discussing the state of value-based care policy and how to improve it. From APG’s view, Berwick and Gilfillan got some things right, but also made some missteps.
In their editorial, Berwick and Gilfillan essentially attacked Medicare Advantage payers, private equity and venture capital-based groups, and others for what they consider to be a money grab from CMS. APG took issue with their recommendation to eliminate risk coding within two years and replace it with an unspecified alternative. APG views risk coding as an essential and fundamental component of measuring a patient’s relative health. In response to the attack on the effectiveness of Medicare Advantage, Crane cited a statistic indicating seniors are opting into Medicare Advantage at increasing rates (26M of seniors eligible for Medicare are opted into Medicare Advantage in 2020 vs. 13M in 2012). I think there will be more to come on this, but APG’s stance appears to be on very solid footing at the moment.
Health equity was a topic of discussion in several sessions, including an excellent preconference session titled “The Connections Between Structural Racism and Health Equity: Interventions and Cultivating Change” featuring keynote speaker Sandra R. Hernandez, (MD, President and CEO of California Health Care Foundation). The Integrated Healthcare Association (IHA) hosted another session which updated the audience on IHA’s California Regional Health Care Cost & Quality Atlas. An important element of the update was IHA’s new focus on equity in addition to cost and quality analyses and insights.
The session titled “Measuring Accountable Performance for Cost, Quality and Equity,” lead by Dan Mendelson (CEO of Morgan Health at JPMorgan Chase & Co.), spoke about bringing a value-based care approach to the self-insured employer market. In addition to accountable care, care navigation, and population health, Morgan Health is focused on Social Determinants of Health (SDOH) and structural inequities. SDOH include factors such as economic stability, physical environment, education, food, social and community context, and underlying health problems. Structural inequities, which include discrimination, racism, language and culture, and lack of diversity, were also discussed as contributors to health disparities driven by a range of systems and social factors where self-insured employers have a role to play.
It was encouraging to see firsthand that the brightest minds in value-based care are still pushing the envelope to improve quality, reduce costs, and improve patient and physician satisfaction. Beyond this, many groups feel there is more work to be done on health equity to ensure their patients are receiving the appropriate care, support, and attention they deserve.