Physicians vie for a greater share of NY's MCO tax proceeds
Beat Memo
A new tax on managed care organizations is expected to net $3.7 billion over the next two years for Medicaid, and health care industry stakeholders all have different ideas for how the state should use it.
SOMOS Community Care, a Bronx-based physician network, will bring hundreds of primary care doctors to Albany this week to push its proposal: a $300 million independent physician investment fund.
Physician associations would apply for funds to expand service offerings, create 'risk reserves' so they can enter more advanced value-based payment contracts, distribute staff bonuses or invest in technology for quality improvement, for example.
The program would be funded at $300 million annually for three years and administered by Medicaid managed care plans, in keeping with guidance from the state Department of Health on how funds should be allocated.
'Family doctors are the front line of prevention and wellness, especially those that serve Medicaid patients,' Ramón Tallaj, board chair for SOMOS Community Care, said in a statement to POLITICO. 'We maintain health care, not sick care, which significantly improves patient outcomes and saves money.'
'By investing in independent primary care, New York can ensure that doctors across the state can provide the care our communities need, treat conditions before they are critical and make our entire system more effective and efficient,' Tallaj added in the statement.
As SOMOS officials note, hospitals have typically been the primary beneficiaries of the state's investment pools for health care facilities — and that's the case under Gov. Kathy Hochul's executive budget proposal for the MCO tax proceeds.
SOMOS is among several organizations pushing for primary care doctors to get a larger piece of the pie.
Under Hochul's proposal, $50 million from the tax would support an increase in the Medicaid physician fee schedule, and $10 million would support enhanced rates for health clinics and federally qualified health centers.
ON THE AGENDA:
— Monday at 11 a.m. The New York State Coordinating Council for Services Related to Alzheimer's Disease and Other Dementia will meet.
— Monday at 4:30 p.m. The Senate and Assembly will hold a budget meeting on mental hygiene.
— Tuesday at 1 p.m. The Senate Health Committee will meet.
— Tuesday at 4:30 p.m. The Senate and Assembly will hold a budget meeting on health.
GOT TIPS? Send story ideas and feedback to Maya Kaufman at mkaufman@politico.com and Katelyn Cordero at kcordero@politico.com.
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What you may have missed
— Six years ago, Rockland County was at the center of the worst measles outbreak in the U.S. in decades. Now as the disease is on the rise nationally, health care workers are putting pressure on local officials to take action, POLITICO Pro reported.
Just 62 percent of children countywide received one dose of the measles vaccine by the age of two, compared with 81 percent statewide, according to state data as of Jan. 1.
A group of 31 doctors and nurses sounded the alarm in a letter to Rockland County Executive Ed Day on Thursday. Day oversaw the local response during the 2018-2019 measles outbreak.
'We take the health and safety of our residents incredibly seriously and strongly disagree with the assertions made by the uninformed signatories of the letter,' Rockland County spokesperson John Lyon said in a statement. 'The County is taking action and has been communicating directly with hundreds of healthcare providers, community leaders and local elected officials to encourage immunization.'
Odds and Ends
NOW WE KNOW — The New York City Health Department is investigating two pet cats that died after being infected with bird flu.
TODAY'S TIP — Got asthma? It's time to start preparing for spring allergy season.
STUDY THIS — Medical device manufacturers have to report adverse events within 30 days, and a new study found most late reports were submitted by a small number of companies.
What We're Reading
— Patients who try to quit benzodiazepines like Xanax are suffering extreme anxiety, memory loss and intense physical pain. (WSJ)
— Keeping with Kennedy's advice, measles patients turn to unproven treatments (New York Times)
— At NIH, 'everyone is on edge' as they brace for deep cuts and more centralized control. (STAT)
Around POLITICO
— CDPAP subcontractors press for more time to switch to new system, Katelyn Cordero and Maya Kaufman report.
— Europe's drug shortage plan looked like a win for the EU and U.S. — until Trump got involved, Helen Collis and Lauren Gardner report.
— Senate Republicans stymie Democrats' bid to pass bipartisan health package, Ben Leonard reports.
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