AAFP Statement: AAFP Disappointed CMS Must Implement Physician Payment Rule That Perpetuates Flawed SGR, Threatens Double-Digit Cuts

Wednesday, Nov. 27, 2013

Statement attributable to:
Reid Blackwelder, MD
American Academy of Family Physicians:

"The Centers for Medicare & Medicaid Services’ final 2014 Medicare physician pay schedule indicates the country may slowly be moving in the right direction in establishing a health care system that meets patients’ needs for a usual source of care and a continuous relationship with a primary care physician.

"As part of efforts to expand access to primary care services, the final regulation further discusses two new codes payable in 2015 for chronic care management services that will strengthen advanced primary care practices. Elderly and disabled patients have complex, multiple, and chronic health conditions that require the whole-person medical attention available only through primary care physicians. Placing appropriate value on the primary care services these patients require and establishing codes for chronic care management are important steps in meeting their needs.

"But the AAFP is disappointed that current law continues to require CMS to issue a physician fee schedule that slashes payment by 20.1 percent next year. The schedule reflects the flawed sustainable growth rate formula that dictates Medicare payment for physician services.

"That formula must be repealed, and the AAFP urges Congress to act quickly to do so. For more than a decade, the physician community has seesawed between threats of serious financial harm due to double-digit SGR cuts and short-term reprieves from that harm. They have urged Congress to give elderly and disabled patients — as well as military families that depend on Tricare — health security by repealing the SGR and replacing it with a system that coordinates care among the patient’s health team members, improves efficiency, ends duplication and fragmentation, and results in improved patient outcomes.

"Congress has a vehicle to do just that. Though in need of refinement, the recent House Ways and Means and Senate Finance committees’ bipartisan proposal to repeal the SGR would implement policies that better support the primary care patient-centered medical home, and shift the focus away from fee-for-service systems that foster episodic, preventable inpatient care, and fragmentary care.

"Congress has begun to appreciate the dire shortages of primary care physicians and other professionals. We again call on Congress to repeal the flawed sustainable growth rate formula that imposes annual threats to elderly and disabled patients’ access to needed health care and undervalues the role of primary care physicians.”

Editor's Note: To arrange an interview with Dr. Blackwelder, contact Janelle Davis, 800-274-2237, Ext. 5222, or jdavis@aafp.org.

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Founded in 1947, the American Academy of Family Physicians represents 134,600 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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