Following long-term advocacy by the AAFP, CMS implemented historic Medicare payment increases for family medicine on January 1, 2021. In 2019, CMS finalized increased payment rates for outpatient evaluation and management (E/M) services, which make up the foundation of family medicine, beginning in 2021. The AAFP strongly supported these payment increases and worked to ensure that CMS implemented them as planned.
Our efforts included both regulatory and legislative activities as Congress also weighed options to provide additional financial relief to physician practices of all specialties amid COVID-19. In addition to ensuring that the E/M improvements went into effect as planned, the AAFP secured equitable financial relief for family physicians when Congress included a 3.75% increase to all Medicare payments for 2021.
Together, the E/M improvements and this relief will result in significant Medicare payment increases for family physicians in 2021. While the COVID-related relief is temporary, the payment increases for outpatient E/M services represent a historic step forward in appropriately valuing primary care.
In December 2020, Congress also passed legislation freezing for two years the thresholds that physicians participating in advanced alternative payment models must meet in order to be eligible for incentive payments. The AAFP had long advocated for such a freeze to ensure that alternative payment models continue to be accessible for family physicians.
The first performance period of the Primary Care First model began in January 2021. The model is focused on practices that provide advanced primary care and are ready to assume financial risk in exchange for reduced burden and performance bonuses. Many of the components of this model were recommended by the AAFP, and we continue to support alternative payment models that use prospective, risk-adjusted, population-based payments for primary care.
The AAFP partnered with other physician organizations to help introduce legislation in both the House and the Senate to increase Medicaid reimbursement rates for primary care services to at least Medicare levels.
The Academy will continue working with its champions in Congress to pass legislation to increase Medicare and Medicaid payments for primary care and support alternative payment models.
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