Final Physician Fee Schedule Disappointing Despite Move Toward Reinforcing Primary Care

Tuesday, Nov. 2, 2016

Statement attributable to:
John Meigs, Jr., MD
American Academy of Family Physicians

"With the release of the final 2017 Medicare Physician Fee Schedule and the creation of new primary care codes, the Centers for Medicare & Medicaid Services has demonstrated its commitment to reinforcing primary medical care and Americans’ access to high-quality health care. However, the American Academy of Family Physicians is disappointed that some provisions of the fee schedule fall short.

“As our health care system moves away from a fee-for-service model toward comprehensive value-based payment, we as a country must further build our primary care foundation. Family physicians and their primary care colleagues provide the first contact care that patients receive. They provide comprehensive preventive services, diagnosis and treatment on short-term and chronic conditions, and coordination with each patient’s health care team for complex health problems. Without a strong primary care foundation, the fragmentation, duplication and unnecessary costs that have plagued America’s health care system will continue despite efforts to increase the quality of care.

“The AAFP strongly supports the fee schedule’s expansion of the Medicare Diabetes Prevention Program. And while we welcome the additional codes for complex chronic care management, mental and behavioral issues, and cognitive impairment or mobility-related disabilities, we will continue to advocate that patients not be charged a copay for these and other chronic care management services. We also remain concerned about the overly burdensome documentation requirements for these services and the level of complexity this adds to the provision of these services.

“However, the AAFP is quite disappointed that CMS only finalized misvalued code changes that achieve 0.32 percent in net expenditure reductions. Since these changes do not fully meet the misvalued code target required by law, physicians will not receive MACRA’s positive 0.5 percent update in 2017. The 2017 Medicare Physician Fee Schedule conversion factor will be $35.89, an increase of only nine cents from the 2016 conversion factor. This result violates the spirit of the Medicare Access and CHIP Reauthorization Act.

“The AAFP is growing increasingly concerned that CMS is adding regulatory burdens to primary care physicians such as consulting appropriate use criteria for advanced diagnostic imaging. This troubling program will divert resources from patient care and is unproven in efficacy. The AAFP has ongoing, significant concerns about the disproportional burden primary care physicians will face when trying to comply with appropriate use criteria requirements. We believe these requirements will place more burdens on primary care physicians than on other providers and add an unnecessary level of complexity that severely overtaxes our members. We are concerned that CMS is unable to find a solution to align this program with the Merit-Based Incentive Payment System being put into place.

“Reforming the physician payment system will unfold over time. As CMS moves to replace payment for individual procedures with payment for value and quality of care, it’s important to preserve the primary medical care that supports the system-wide reforms taking place today and for years to come.”

Editor's Note: To arrange an interview with Dr. Meigs, contact Leslie Champlin, (800) 274-2237, Ext. 6252, or


# # #

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.

To learn more about the AAFP and family medicine, visit Follow us on Twitter,( and like us on Facebook. For information about health care, health conditions and wellness, visit the AAFP’s award-winning consumer website,