November 30, 2020

Volume X, Number 335


Advancing Primary Care in Washington, DC, in 2021

With the 2020 election almost in the rearview mirror, clinicians and policymakers alike are turning their attention to the 2021 agenda. For primary care providers, 2021 will hopefully bring COVID-19 recovery and response efforts, additional opportunities to pursue value-based payment arrangements, and ongoing deployment of telehealth and virtual technology.

The 2020 presidential election is expected to bring about a change in administration. However, the “blue wave” Democratic sweep projected by some pundits and pollsters failed to materialize. Instead, in Washington, DC, we will have a closely divided US Senate, with the final balance of power to be determined by two run-off races in Georgia. The US House of Representatives will remain in Democratic control, but by a smaller margin. The narrow margins in the House and Senate will likely constrain the extent to which Democrats are able to advance progressive policy changes. Instead, both sides of the political aisle in Congress are likely to focus on bipartisan areas of agreement. For primary care clinicians, this environment may be encouraging, as members of both parties share goals around protecting and advancing primary care across the country.

COVID-19 Response

When the new Congress begins and President-Elect Biden is inaugurated in January 2021, COVID-19 relief is expected to be at the top of the agenda. Expect President-elect Biden and the incoming Congress to pursue economic and public health relief. Clinicians across the country who have faced depressed revenue as a result of the pandemic look eagerly ahead to another relief package that could provide additional funding for practices experiencing dramatic shortfalls.

Value-Based Payment Arrangements

The COVID-19 pandemic has underscored the vulnerability of a fee-for-service payment system that rewards clinicians for volume. It has also highlighted the potential opportunity associated with models that blend or rely on pre-payment or a per-member-per-month approach. The Trump Administration advanced several delivery models that continue to test the effectiveness of such approaches. Expect the Biden Administration to continue to advance these types of models while putting its own stamp on the details.

Telehealth and Virtual Care

The pandemic also sparked significant uptake of telehealth and virtual health across the United States. In 2021, Congress and the administration will need to determine which of these temporary telehealth waivers can endure beyond the pandemic. Stakeholders will need to continue to educate policymakers about how telehealth services fit into the broader care continuum and to define the policy goals of extending existing waiver flexibilities.

Prepare for an Active Year in Primary Care Policy

Expect 2021 to be another active year in primary care policy. We anticipate significant developments in both the administration and Congress that will shape the delivery of healthcare services for years to come.

© 2020 McDermott Will & EmeryNational Law Review, Volume X, Number 324



About this Author

Mara McDermott, McDermott Law Firm, Washington DC, HealthCare Law Executive

Mara is an accomplished health care executive with a deep understanding of federal health care law and policy, including delivery system reform, physician payment and Medicare payment models.

Most recently Mara served as the senior vice president of federal affairs at America’s Physician Groups (formerly the California Association of Physician Groups, CAPG), a professional association representing medical groups and independent practice associations practicing in capitated, coordinated care models. As head of the Washington, DC, office, Mara...