Private Payer Issues
The AAFP advocates to the six largest health plans for family physicians. The AAFP private payer advocacy agenda includes but is not limited to:
- Holding private payers accountable for a commitment to increase investment in primary care.
- The need for payers to support practices in value-based contracts.
- Advocating for reduced or eliminated prior authorizations.
- The need for administrative simplification by advocating for the adoption of the Core Quality Measures Collaborative’s core measure sets.
Letter to Blue Cross Blue Shield Rhode Island (BCBSRI) Opposing Their Modifier 25 Policy
In response to BCBSRI’s modifier 25 policy, the AAFP sent a letter asking them to re-evaluate their modifier 25 reporting and payment policy.
The letter voices concern that BCBSRI’s modifier 25 policy significantly hampers family physician’s ability to financially operate a medical practice and transition to value-based care. It also is detrimental to patient access to care.