Congress continues to weigh how telehealth should be treated after the public health emergency ends. In late April, the House Ways and Means Health Subcommittee held a hearing on the path forward for telehealth. Witnesses included Sinsi Hernández-Cancio of the National Partnership for Women and Families, a PCC Executive Member, whose testimony called for the implementation of telehealth that reduces and does not exacerbate longstanding health inequities.
 
Several telehealth-related bills have been introduced in both the House and Senate. The CONNECT for Health Act of 2021 proposes permanently lifting or expanding geographic and site-based restrictions, permanently allowing for waivers during public health emergencies and requiring studies on the impact of telehealth on utilization and care. PCC and several of its members have signed on to the legislation, which has 56 co-sponsors and over 160 supporting organizations.
 
Other bills include the Permanency for Audio-Only Telehealth Act, re-introduced in the House, that would allow Medicare to permanently cover audio-only visits, and the Telehealth Improvement for Kids’ Essential Services, introduced in the Senate earlier this week, that looks to expand telehealth access for enrollees in Medicaid and CHIP. 

Primary care payment models out of the Center for Medicare and Medicaid Innovation have seen a number of updates in recent weeks. Practices that joined the Comprehensive Primary Care Plus (CPC+) model in 2018 recently learned that their fifth year of the model (anticipated for 2022) would be canceled. The CPC+ program will now end for all practices on December 31, 2021.
 
Separately, application deadlines for the Primary Care First model were extended: Practices interested in joining Cohort 2 should apply by May 21; payers have until June 18. While CMMI announced the 53 organizations participating in the Global and Professional Direct Contracting Model’s first performance year (which began April 1), it also announced that it would not be opening applications for 2022 as originally planned. Previously, the Geographic Direct Contracting model had also been put on hold while under review.

COVID-19 continues to take a disproportionate toll on communities of color. A recent study found that Black women are three times more likely than White men to die from COVID-19. And this month, the CDC released a pair of studies further highlighting the pandemic’s inequities, finding that Hispanic and Latino patients made up the highest proportion of hospitalized patients with COVID-19 across all four census regions. A new West Health/Gallup survey of Americans found that nearly one in five skipped health care over the last year because of cost concerns; Black adults (29%) were almost twice as likely to not afford care as compared to White adults (16%). The administration is responding, in part, by targeting funds to Community Health Centers and other locations that serve more low-income patients.
 
In early April, HHS expanded its COVID-19 vaccine program to all health centers—nearly 1,500—and Tuesday announced $1 billion for health centers to make COVID-19 related capital investments. HHS also recently announced $145 million for health center lookalikes (community-based practices that meet Health Center Program criteria but are not grantees) to respond to and mitigate the spread of COVID-19 while expanding vaccination efforts.

The White House and CDC are looking to help states better incorporate primary care into their COVID-19 vaccination strategy. They have launched a three-pronged effort that includes:

• providing states with accessible lists of enrolled medical offices that are eligible to administer the vaccine, prioritized by social vulnerability data
• working with states to enroll more primary care clinicians to administer the vaccine
• providing technical assistance to jurisdictions to support distribution and enrollment activities

The federal government does not plan to make any direct allocations of vaccine to primary care, apart from the existing health center program. The administration’s plan comes at a time when many primary care practices are asking to play a more active role in COVID-19 vaccination efforts but lack supply and local/state coordination. The latest Larry A. Green Center/PCC survey of primary care clinicians shows that more practices are now administering COVID-19 vaccines but still not a majority.