AMGA Urges Biden Administration to Turn to Medical Groups as Vaccination Locus

Feb. 2, 2021
Leaders at AMGA sent a letter to the White House urging the administration to look to multispecialty medical groups as a key locus for COVID-19 vaccination, following the release of a White House plan on vaccination

On Monday, Feb. 1, the leaders at the Alexandria, Va.-based AMGA (American Medical Group Association) sent a letter to President Joe Biden and the Biden administration asking that they consider multispecialty medical group practices as a key resource in terms of getting the hundreds of millions of Americans vaccinated who need to be vaccinated during the current COVID-19 pandemic. The association represents 175,000 physicians practicing nationwide, and caring for roughly one-third of Americans.

As AMGA noted in a press release on Monday, “AMGA today recommended the Biden Administration enlist multispecialty medical group practices to inoculate patients against COVID-19 and reach the president’s goal of vaccinating 100 million people in 100 days. While this is a daunting figure, AMGA members have the capacity, as well as the experience and expertise with vaccination campaigns, to vaccinate millions of patients and help reach the goal. AMGA member medical practices have the information technology infrastructure and staff needed to safely schedule and administer COVID-19 vaccines. By tapping these resources, AMGA members can ameliorate the burden on community vaccination centers and provide additional access points to the vaccine.”

“President Biden has a solid plan to increase the number of people who are vaccinated,” said AMGA president and CEO Jerry Penso, M.D., in a statement in the press release. “AMGA members have the capacity to vaccinate millions of patients, something they do every year, but they also are a source of comfort and trusted information for our patients. Instead of asking patients to navigate an unfamiliar website to schedule a vaccine, our members’ care managers can schedule appointments as part of a vaccination clinic and allow patients to remain safe in their homes until it is their turn, rather than waiting in a parking lot.”

As the press release noted, “AMGA’s recommendations build on President Biden’s National Strategy for the COVID-19 Response and Pandemic Preparedness. While AMGA recognizes and supports the need for community vaccination centers, the federal response also should coordinate with medical group practices. Our members’ electronic medical records can identify and alert providers to which patients are eligible for vaccination. Then, it will trigger an alert so case managers can follow up with patients and ensure they receive a second dose at the appropriate time. Relying on group practices to schedule appointments will relieve some of the responsibility from county health departments or other community vaccination efforts for tracking patients.”

In the letter to President Biden and the administration, Dr. Penso noted that Every dose provided in one of our members’ offices means one fewer person in line at a community vaccination center. Given the vaccines require a second dose, our established relationships with our patients will facilitate the scheduling, care management, and documentation needed to ensure patients adhere to the vaccine protocols. AMGA member practices have the infrastructure needed to schedule appointments so that patients can remain at home until their appointment rather than waiting in line at a vaccination center. Our electronic medical records can identify and alert providers to which patients are eligible for vaccination. Then, it will trigger an alert so case managers can follow up with patients and ensure they receive a second dose at the appropriate time. Relying on group practices to schedule appointments will relieve some of the responsibility from county health departments or other community vaccination efforts for tracking patients. In addition, rather than require patients to navigate an unfamiliar state or county website, or travel to a new location, patients can contact their trusted clinicians to schedule an appointment at the appropriate time and in their usual care setting. Even more importantly, our providers have the ability to reach out to patients and contact them.”

And, Dr. Penso said, “As additional supplies of vaccine become available, coordinating with group practices will be an important aspect of the distribution effort. Our members have the storage and staffing requirements necessary for the vaccine, but practices should be notified three to four weeks in advance of the number of doses they will receive. This will allow our members to plan vaccination clinics at their facilities.”

What’s more, Penso said in the letter, “Providing medical groups access to the vaccine also will allow our medical providers to begin to resume regular operations. Delayed and deferred care is a serious matter. By running a vaccination clinic in a medical group’s office, as is commonly done, patients also will benefit by having the opportunity speak with their providers about other healthcare concerns. Follow-up care can then easily be scheduled and provided. AMGA members are accustomed to providing a number of vaccines to our patients. Their experience with seasonal, high-volume influenza vaccination, along with other routine vaccinations, is a resource that is ready to serve our communities. With a dedicated supply of vaccine and support, including the necessary financial support for staff, tents, and the other logistical needs to manage vaccine operations, medical groups are well positioned to quickly help you reach your vaccination goals.”

On Tuesday, Feb. 2, Darryl Drevna, AMGA’s senior director, regulatory affairs, spoke with Healthcare Innovation Editor-in-Chief Mark Hagland regarding the letter to the Biden administration and its background. Below are excerpts from that interview.

Tell me about the origin of the development of the letter?

President Biden recently released a strategic plan. And the administration spells out seven points. Two jumped out at us. One was a robust vaccination campaign. And their plan pretty much says, we need as many axis points as possible to distribute the vaccine as quickly and efficiently as possible. Physician offices are mentioned, but there’s an emphasis on community vaccination centers and retail centers. I think what they’re missing is what we’ve been building on for years, and we’re concerned that they’re leaving some things on the field.

They want to prioritize senior citizens and people with chronic diseases. These are our patients; we know them and work with them already. So our strong recommendation is that they include group practices and systems of care. Let us schedule our patients; they know how to come into our offices; we’ve been doing this with influenza and pneumonia for years. And per the tracking, especially around the two-dose drugs. You don’t need to have a patient have to navigate a website and then go somewhere unfamiliar. With one of our medical group practices, you go into a familiar place, and everything’s logged into the EHR and automated, and the follow-up visit is scheduled. We can schedule them right away, versus pushing them towards unfamiliar locations. Plus, that’s one less person in line at a county facility, for example. So let’s tap this resource.

Do they know that you’re speaking out about this?

We sent it over yesterday, and haven’t received a response yet.

There’s a lot of confusion out there around vaccination, overall. Most consumers are not getting the information they need. Perhaps that speaks to your letter?

Yes, there are a couple of things going on. And in terms of actually putting needles into arms, that’s where we can help out. This is a bit outside of my area, but clearly, there’s a shortage of vaccine doses right now. So the states are working on that. The previous administration was focused on developing and approving vaccines, but not on the next step.

The Biden administration people said last week that, when they came into office, that there really was no functioning vaccine distribution plan under the Trump administration.

I can’t speak to that, but clearly, there was some confusion around all this, which is why the Biden administration put out this plan, which is what our letter speaks to. And we just to make sure that, as they go through the process, they’re touching base with relevant stakeholder groups, like us. Our membership was very interested in this. And we strongly believe that consumers shouldn’t have to go to county- or state-run community vaccination centers, they should be able to come to their physician practices, once the supplies are available to multispecialty group practices, and not just rely on walk-in clinics.

What’s your sense of timeframe around all of this?

I think it’s all dependent on how quickly they can get the supply. It’s really dependent on what the level of vaccine availability looks like. Until there’s a sufficient supply of vaccine, you’ll see the ongoing confusion over where it’s going, which groups are prioritized, etc. These are all manifestations of a shortage. And everyone understands that. We’re just asking that they let us be ready to be called in off the bench. Because people are going to these community vaccination centers and are getting their first dose, and then are disappearing, per the second dose. And that’s where we really can play a role. And if a patient doesn’t show for some reason, the IT infrastructure is in place, so that if Mrs. Smith doesn’t show up for the second appointment, the system will flag a care manager, and we can correct that problem really quickly.

Is there anything that you’d like to add?

This looks like a clearly well-thought-out plan by the administration; we’re just looking to improve it and to make sure that they know they’ve got a resource available to help in this national fight.

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