The Medicare Payment Advisory Commission (MedPAC) renewed its call for greater support for primary care physicians in its latest annual report to Congress.(medpac.gov)
For years MedPAC has sought to bolster primary care through increased Medicare payments or financial incentives funded by lowering subspecialty payment rates. This year, the commission said Congress should increase 2017 payment rates for physicians and other health professionals as the law requires.
"The Commission remains concerned that the fee schedule and the nature of (fee for service) payment leads to an undervaluing of primary care and overvaluing of specialty care," the report states.
The report noted the salary disparity between primary care and other specialties and raised concern that services for many subspecialists are "mispriced" in the Medicare Physician Fee Schedule. It called the fee schedule "an ill-suited payment mechanism for primary care."
The report specifically said better primary care management of risk factors associated with kidney disease such as hypertension and diabetes could help prevent onset of the disease.
"The commission has long argued that primary care providers are undervalued in Medicare's fee schedule and has made recommendations to support primary care, which in turn could support better management of kidney disease risk factors," the report stated.
The annual report, which typically outlines a year's worth of policy recommendations, included results of a survey that asked two groups -- Medicare beneficiaries age 65 and older, and privately insured individuals ages 50 to 64 -- about their access to care. Medicare patients report greater satisfaction with the quality of their care and access to care compared with patients who have private insurance.
Most Medicare beneficiaries said they could see their primary care physician for a check-up within one to two weeks. Most of them could schedule an acute primary care visit on the same day with their physician or another physician in the same practice. Many Medicare beneficiaries said they went to an urgent care facility when they could not see their primary care physician right away.
Most Medicare beneficiaries said they were able to see their primary care physician for acute care, illness or injury. Only 7 percent reported trouble finding a new primary care physician.
Ninety-five percent of Medicare beneficiaries said they have a usual source of primary care and 55 percent have been with the same source for five years or longer.
Only 11 percent of Medicare patients and 12 percent of individuals with private insurance said they did not see a physician for a health problem when they thought they should have in the previous year.
The rate of primary care physicians is growing at the same rate as the Medicare population, the commission reported, holding steady at 3.7 per 1,000 beneficiaries from 2013 to 2014. In 2014 there were 180,165 primary care physicians billing Medicare, a rise from 178,404 in 2013.
The rate of subspecialists dropped slightly from 8.2 per 1,000 beneficiaries in 2013 to 8 per 1,000 beneficiaries in 2014.
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