It has taken more than a decade, but Congress has finally repealed the flawed Medicare Sustainable Growth Rate (SGR) formula.
With more than 100 million total enrollees, the Medicare and Medicaid programs represent the largest and most far-reaching health plans in the country. For nearly 50 years, these landmark initiatives have supported critical health care access for young and old alike, while providing an essential revenue base for health care providers.
Today, both programs are evolving rapidly as policymakers and elected officials attempt to reduce costs and improve the quality of care. The AAFP has actively supported these reform efforts as the role primary care can play in improving both the efficiency and quality of care gains widespread recognition.
At the same time, the AAFP understands that primary care physicians must be adequately compensated for the services they provide through means that are responsible without imposing excessive administrative burden. That’s why we will continue to advocate on behalf of family physicians to ensure that Medicare and Medicaid reimbursements appropriately reflect both the costs of clinical services and the new duties and responsibilities primary care physicians are taking on in the current reform-driven environment.
Monitor an innovative new program that is providing bonus payments to primary care doctors who better coordinate patient care.
Explore provisions in the Patient Protection and Affordable Care Act (ACA) that increase payments for a range of Medicaid primary care services to Medicare levels for specified primary care physicians.
Understand why the current formula for Medicare reimbursement is fundamentally flawed and learn what the AAFP is doing to create a new, more effective payment model.
Understand the RUC’s role in valuing services provided by family physicians.
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