CMS Releases 2011 Data on Primary Care Incentive Program

Family Physicians, General Internists Receive Bulk of PCIP Payments

May 31, 2012 05:50 pm News Staff

Most of the funds awarded via the Primary Care Incentive Payment (PCIP) program in 2011 went to family physicians and general internists, according to data( recently released by CMS.

[Primary Care Incentive Payment Distribution by Specialty]

The agency distributed about $560 million via the PCIP program in 2011. Fifty percent of those funds went to general internists and 38 percent went to family physicians. The majority of funds, 86 percent, went to physicians in urban areas, and the remaining 14 percent went to rural areas, according to CMS data.

In terms of actual participation numbers and dollar amounts, 61,728 family physician practices received nearly $213 million from the PCIP program in 2011 compared to 55,329 general internist offices that received nearly $280 million. Nearly 2,200 pediatric offices received about $1.7 million from the program in 2011, and 1,391 geriatricians got 1.7 percent of the funds.

The PCIP program, which was created by the Patient Protection and Affordable Care Act, requires Medicare to pay primary care providers, whose primary care billings comprise at least 60 percent of their total Medicare allowed charges, a quarterly 10-percent bonus from Jan. 1, 2011, until the end of December 2015.

AAFP leaders urged CMS to release the data during a meeting with CMS officials in February and in a follow-up letter to CMS Administrator Marilyn Tavenner, M.A. In the letter, AAFP Board Chair Roland Goertz, M.D., M.B.A., told Tavenner that CMS was missing an important opportunity to showcase the PCIP by failing to provide data on the program.

"We urge CMS to continue to highlight the law's practical effect on primary care physicians by immediately releasing aggregate PCIP data," Goertz said.

Goertz also noted PCIP data play an important role in efforts to replace the sustainable growth rate formula and address the current payment discrepancies between primary care physicians and medical subspecialists.