AAFP Statement: MedPAC Interim Recommendations Acknowledge the Need for Improved Payment for Primary Care

Wednesday, September 21, 2011

Statement Attributable to:
Glen Stream, MD, MBI
American Academy of Family Physicians

“The American Academy of Family Physicians applauds the Medicare Payment Advisory Commission for acknowledging in its draft recommendations on repealing the Medicare sustainable growth rate formula that primary care is the foundation for a high-functioning health system that ensures patients have access to the comprehensive care they need.

“Primary care has been conclusively shown to improve patients’ outcomes, end fragmentation and duplication, and help rein in costs. It is key, therefore, in achieving the goal of better care, better health, and lower costs. 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.

“Repealing the SGR comes with a price, however. The MedPAC recommendation that Congress legislate a 10-year freeze on Medicare payment to primary care physicians will not protect patients’ access to care, a stated goal of MedPAC. Instead, it will threaten all patients’ access to care.

“After years of meager, unpredictable Medicare updates and significant inflation, many family physicians struggle to maintain their practices. 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.

“A payment freeze also 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.

“The AAFP calls on MedPAC to recommend both a positive annual update and a positive payment differential to the Medicare conversion factor for primary care physicians over this 10-year period as an even stronger signal of the importance and value of primary care to a better health care system for the people of America.

“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."

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

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Founded in 1947, the American Academy of Family Physicians represents 136,700 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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