Medicare Payment

See also

The AAFP calls for a realignment of Medicare payment to reflect more equitable payment for services provided by family physicians. With regard to 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 that 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 for all physician services under the Medicare Fee Schedule, except for purposes to achieve specific public policy goals;

(e) Opposes expenditure targets, including the Sustainable Growth Rate, in favor of a system 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, which physicians use to provide services and that are adjusted in a timely and understandable manner;

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

(h) Supports the elimination of all geographic adjustment factors from the Medicare 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-month care management fee for family physician practices that function as a patient-centered medical home; and

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

(k) Supports a performance bonus based on evidence-based performance measurement; and

(l) Develops new payment methodologies to assure fair payment for primary care services.

(1973) (2011 COD)