• Medicare Payment

    The AAFP calls for a realignment of Medicare payment to reflect more equitable payment for services provided by family physicians. Regarding payment for physicians' services under Medicare, the AAFP:

    (a) Continues to oppose mandatory assignment for physicians under the Medicare program;

    (b) Opposes the limiting charge program, which unfairly limits the payment of nonparticipating physicians;

    (c) Supports the need for Medicare beneficiaries to receive clear and understandable reports about the payments made, or not made, on their behalf, while avoiding potentially unsupportable phrases, such as "not medically necessary;"

    (d) Supports the use of a single conversion factor, if a conversion factor exists, for all physician services under the Medicare Physician Fee Schedule, except for purposes to achieve specific public policy goals;

    (e) Opposes expenditure targets and supports adjustments to the conversion factor based on the Medicare Economic Index or another fair representation of physicians' costs of delivering care;

    (f) Supports practice expense relative value units (RVUs) that are based on the actual resources, both direct and indirect, physicians use to provide services and that are adjusted in a timely and understandable manner;

    (g) Supports work RVUs that appropriately value evaluation and management services relative to procedural services;

    (h) Supports the elimination of all geographic adjustment factors from the Medicare Physician Fee Schedule except for those designed to achieve a specific public policy goal (e.g., to encourage physicians to practice in underserved areas);

    (i) Supports additional payment models including, but not limited to, a per-patient per-month care management fee for family physician practices that function as a medical home;

    (j) Supports Medicare Fee-for-service payment for physician services according to a Resource-Based Relative Value Scale (RBRVS) that supports primary care;

    (k) Supports Medicare Advantage plan payment to physicians at the level of traditional Medicare fee-for-service or higher;

    (l) Supports a bonus payment mechanism based on evidence-based performance measures consistent with AAFP policy on "Performance Measures Criteria"; and

    (m) Supports development of alternative payment models to assure fair payment for primary care services and to measure and address population health equity.

    (1973) (September 2022 COD)