AAFP Statement: Proposed Medicare Fee Schedule Underscores Need for Physician Payment Reform

Friday, July 01, 2011

Statement attributable to:
Roland Goertz, MD, MBA
President, American Academy of Family Physicians

“The proposed 2012 Medicare physician fee schedule demonstrates, once again, the instability of the Medicare payment system. The threat of drastic pay cuts for medical services, followed by a short-term patch to the system, followed by another threat of pay cuts has been an ongoing struggle since 2003. It’s time to end the cycle.

“Family physicians and our colleagues throughout the medical community find it very challenging to develop workable business plans to maintain the financial viability of their practices under these circumstances. Congress must reform Medicare payment so that patients know they have access to care when they need, physicians can be assured of appropriate payment for their expertise and the health care system as a whole can anticipate and control costs without shifting those costs onto the shoulders of physicians and other health care providers.

“The American Academy of Family Physicians has consistently called on Congress to prevent these drastic payment cuts and to end the practice of enacting retroactive “fixes” to the flawed sustainable growth rate formula on which Medicare payment is based.

“This is a long-term process — one that requires time to develop and implement permanent changes that will improve the quality of care and help restrain growth in health care costs. Research has consistently demonstrated the model that best meets these goals is the patient-centered medical home. The PCMH provides not only the first contact a patient has with the health care system, but also the preventive care, management of chronic conditions and coordination of services provided by all the other members of a patient’s health care team.

“In order to succeed, Congress should provide a five-year extension of Medicare payment updates that — in order to build the much needed primary care physician workforce — includes a 3 percent positive payment differential for primary care physicians providing primary care services and continued Primary Care Incentive Payment.

“During this five years, Congress should work with the medical community to develop and implement system reform that builds the patient-centered medical home, rewards prevention and wellness, eliminates fragmentation and duplication, and results in a cohesive system of care that prevents unnecessary complications from acute or chronic illness, hospitalizations, and other avoidable expenses.

“Only by putting value into the outcome of our services can we ensure better health for our patients and rein in spiraling costs. We call on Congress to end the cycle of threatened cuts and retroactive patches and to permanently reform the Medicare payment system. Only then will our health care system regain the stability that assures our patients access to the care they need, when they need it.”

Editor’s Note: To arrange an interview with Dr. Goertz, contact Leslie Champlin, 800-274-2237, Ext. 5224, or lchampli@aafp.org.

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Founded in 1947, the AAFP represents 129,000 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit
www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website, www.familydoctor.org(www.familydoctor.org).