Proposed Part B Medication Payment Model Promises Improved Patient Access and Efficiency

Wednesday, March 9, 2016

Statement attributable to:
Wanda Filer, MD, MB
President, American Academy of Family Physicians

“Family physicians welcome the opportunity to improve methods by which the Centers for Medicare & Medicaid Services pays for Medicare Part B medications that patients receive in physician offices or hospital outpatient departments.

“The transformation of our health care system requires a fresh perspective and new ideas on how we deliver and pay for health care services. The AAFP applauds CMS’s efforts to apply common-sense, value-based payment principles to the delivery of physician-administered pharmaceutical and biologic treatments. Physicians, hospitals and other Medicare providers are aggressively pursuing value-based payment models, and it only makes sense that we would explore the applicability of these same ideas to the pharmaceutical industry.

“By seeking public comment on how to test new payment models for physician-administered medications, CMS is taking a step toward ensuring that Medicare patients get the most appropriate drugs while simultaneously minimizing costs for patients and thus the U.S. health care system.

“The proposed rule, if finalized, would test the impact of paying for medications administered in a physician’s office based on average sales price, plus a flat fee and 2.5 percent add-on. Equally important, the CMS proposal would test making these medications more accessible to patients by decreasing or eliminating cost-sharing.

“The AAFP believes that all physicians should be paid accurately for the clinical services they provide and that delivery systems should not favor certain drugs or medical devices over others. This proposed rule offers the opportunity to test program changes that may be an important step in this direction and the AAFP looks forward to providing CMS with a full reaction prior to the comment deadline.”


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

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Founded in 1947, the AAFP represents 136,700 physicians and medical students nationwide. It is the largest 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 For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website,