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Draft Proposal for Medicare Pay Focuses on Primary Care, but AAFP Challenges Approach
MedPAC Recommends Eliminating SGR, but Price for Physicians, Patients Is High
By News Staff
"Primary care has been conclusively shown to improve patients' outcomes, end fragmentation and duplication, and help rein in costs," said AAFP President Glen Stream, M.D., M.B.I. of Spokane, Wash., in a prepared statement. "By recommending that Congress repeal the sustainable growth rate formula on which Medicare payment is based and by calling for a positive payment differential to the Medicare conversion factor for primary care physicians, MedPAC clearly recognizes the immediate need to improve Medicare fee-for-service payment for primary care physicians.
"These are steps in the right direction," said Stream.
- The AAFP is praising the Medicare Payment Advisory Commission, or MedPAC, for its recommendation to eliminate the current Medicare physician payment rate formula.
- The draft recommendations also take steps to better value primary care services.
- However, the 10-year payment freeze for primary care services that MedPAC also is recommending "will be catastrophic, severely challenging family physicians' ability to keep their practices open," according to AAFP President Glen Stream, M.D., M.B.I.
"After years of meager, unpredictable Medicare updates and significant inflation, many family physicians struggle to maintain their practices," said Stream. "Freezing payments for primary care for even one year will be catastrophic, severely challenging family physicians' ability to keep their practices open, much less redesign them for becoming patient-centered medical homes."
Stream also said a payment freeze sends "a negative signal to medical students whose interest in family medicine has increased in the past two years as policy discussions placed greater emphasis on the high value of primary medical care."
Consequently, the AAFP is calling on MedPAC to recommend both a positive annual update and a positive payment differential to the Medicare conversion factor for primary care physicians during the next 10 years to demonstrate the importance and value of primary care in creating a better health care system.
"We would hope that, in deliberating the SGR repeal, Congress and the Joint Select Committee on Deficit Reduction will build on MedPAC's recommendations, establish a payment plan that closes the income gap between primary care and subspecialist physicians and continue progress toward a reformed system that begins with the primary care, patient-centered medical home," Stream said.
MedPAC, meanwhile, plans to finalize recommendations on Medicare physician payment during its next meeting in early October before sending a final recommendation to Congress.
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