Alternative payment model advocacy

Transcending fee-for-service medicine

Cheerful middle aged male doctor in white coat with stethoscope consulting patient in office clinic interior.

Alternative payment models (APMs) are significant opportunities for family physicians ready to escape fee-for-service (FFS) practice and move toward payment policies that promote continuous primary care.

What are alternative payment models?

The Medicare Access and CHIP Reauthorization Act (MACRA) permanently repealed the flawed sustainable growth rate and set up the two-track Quality Payment Program, emphasizing value-based payment models. These models offer physicians incentives to provide high-quality, cost-effective care and move away from FFS medicine.

MACRA defines any of the following as a qualifying APM:

  • An innovative payment model expanded under the Center for Medicare & Medicaid Innovation, with the exception of Health Care Innovation Award recipients

  • A Medicare Shared Savings Program accountable care organization

  • A Medicare Health Care Quality Demonstration Program or Medicare Acute Care Episode Demonstration Program

  • Another demonstration program required by federal law

APMs transcend fee-for-service

Volume-based FFS care does not adequately support true longitudinal primary care and cannot keep costs in check. Value-based care, including APMs, achieves both of these aims while prioritizing quality and outcomes over quantity of services provided.

AAFP’s continued commitment to payment innovation

Physician compensation should recognize the important work family physicians do every day and address the value of prevention, health maintenance, early diagnosis and early treatment. However, budget neutrality requirements and the lack of annual payment updates to account for inflation continue to hurt physician practices and undermine patient care.

The Academy maintains pressure on Congress to enact policies that incentivize practices to transition to value-based payment models that ultimately improve health outcomes for patients and communities.

Recent AAFP communications

Joint communications with other organizations

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