AAFP Calls on Congress to Update Medicare Physician Payment to Support Practices, Patients, Value-Based Care

FOR IMMEDIATE RELEASE
Tuesday, March 15, 2022

Statement attributable to:
Sterling N. Ransone, Jr., MD, FAAFP President
American Academy of Family Physicians

“As physicians across the country work to respond to the COVID-19 pandemic, they are also facing tremendous pressure from a strained, underfunded health care system. We cannot underfinance primary care physicians when their services have never been in higher demand. Medicare’s current physician payment system is undermining physicians’ ability to provide high-quality, comprehensive care. The American Academy of Family Physicians calls on policymakers to update Medicare physician payments to support practices, stem costs for patients, and prevent consolidation. We are disappointed that MedPAC recommended against providing a positive Medicare payment update for physicians. MedPAC has long advised Congress to increase our nation’s investment in primary care, but today’s recommendations run counter to that goal.

“All physicians need increases in Medicare payments to provide quality, comprehensive care to patients, but this is especially true for primary care. Physician services are one of the few sectors that do not receive an inflation adjustment under Medicare. Without a positive payment update and with continued rising costs, we risk forcing independent practices to be acquired by large health systems, further increasing health care costs for patients. Additionally, unsustainable Medicare physician payment rates make it more difficult for practices to invest in the practice transformation and infrastructure changes needed to succeed in alternative payment models and move to value-based care.

“Transitioning to value-based care is broadly recognized as an important step to advancing health equity, as it gives practices the resources and flexibility to provide comprehensive care including addressing unmet social needs that are so important to improving health outcomes. Physicians in alternative payment models are better equipped to provide value-based care that includes enhanced services that are not supported by fee-for-service payment rates. To compound this problem, most alternative payment models use fee-for-service payment rates to

benchmark model payment levels. Thus, outdated Medicare payment rates are undermining the move to value-based care and, in turn, exacerbating our nation’s underinvestment in primary care.

“Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) with the goal of transitioning Medicare Part B payments from a volume-based fee-for-service model toward value-based alternative payment models by eventually providing positive payment updates only to those clinicians who participate in the latter. Unfortunately, MACRA has thus far failed to adequately support clinicians in the move to alternative payment models, leaving the majority in fee-for-service. Until there are more alternative payment model opportunities available for all physicians and they have sufficient time and resources to adopt them, it is imperative to ensure Part B clinicians are adequately paid under the fee schedule.”

“We strongly urge Congress provide a regular, sustainable update to payments made under the Medicare fee schedule and address budget neutrality limitations, which prevent Medicare from investing in high-value Part B services. Finally, any long-term solution must provide meaningful support for physicians to transition into alternative payment models without adding administrative burden. These reforms are urgently needed to provide primary care physicians with the resources they need to provide high-quality, comprehensive care. Only then can we truly improve individual and population health and advance health equity.

“The AAFP looks forward to continuing to work with Congress to build a better payment system for all physicians that will meet the diverse health needs of patients and communities.”

Editor's Note: To arrange an interview with Dr. Ransone, contact Julie Hirschhorn, 202-655-4949, or jhirschhorn@aafp.org.

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