Payment, Care Management Function

The American Academy of Family Physicians supports separate payment for the care management services provided by family physicians and their practices. Payment for care management services should be in the form of a designated care management fee paid on a per-member per-month basis as part of a "blended payment" model that also includes enhanced fee-for-service and performance-based incentives Care management services include, but not limited to, the management and coordination of complex medical cases to ensure quality and efficient use of health care resources. The New Model of family medicine, as exemplified in the patient-centered medical home, anticipates that family physicians and their clinical staff will commonly provide such services. Family physicians already utilize their office nurses for coordination of services for their patients and assuring that appropriate testing and medication compliance occurs in a patient’s treatment plan. Thus, the American Academy of Family Physicians believes that health care delivery and payment systems that use or contract for care management services should pay family physicians appropriately for these services. (1987) (2011 COD)