Through New Pay Model, CMS Wants To Reward Primary Care Physicians For Keeping Patients Healthy, Out Of Hospital
HHS Secretary Alex Azar says the new primary care experiment will transform the U.S. health system, and “move [the nation] toward a system where providers are paid for outcomes rather than procedures, and free up doctors to focus on the patients in front of them, rather than the paperwork we send them.” This new initiative is the most sweeping attempt to date to change primary care. While the program is voluntary, the administration hopes that as many as one-fourth of all primary-care doctors will participate.
The Wall Street Journal:
Trump Administration Launches Program To Rein In Medicare Costs
The Trump administration is launching a program to offer new ways of paying primary-care doctors, including flat monthly payments to physicians and higher payments for medical practices specializing in the chronically ill, as a way to lessen the costs of Medicare’s usual fee-for-service system. Seema Verma, the Medicare administrator under President Trump, said the flat-fee method and other payment alternatives could be a path for the Medicare payment system to achieve better outcomes for patients instead of the current fee-for-service method that creates “perverse incentives to offer more care.” (Burton, 4/22)
Stat:
U.S. Health Officials Unveil Experiment To Overhaul Primary Care
The initiative, called CMS Primary Cares, includes five new payment options for small and large providers, allowing them to take varying levels of financial responsibility for improving care and lowering costs. It broadly seeks to change how primary care is delivered in the U.S. by rewarding doctors for improving management of patients with chronic illnesses such as diabetes and high blood pressure, and averting expensive trips to the hospital. Health and Human Services Secretary Alex Azar called the program “an historic turning point in American health care” that is projected to enroll a quarter or more of the 44 million Americans served by traditional Medicare. (Ross, 4/22)
Modern Healthcare:
CMS To Launch New Direct-Contracting Pay Models In 2020
Larger practices and health systems would have additional choices, which could be very lucrative but pose steeper risks. Under the first "professional option," providers would assume 50% of the risk, including savings and losses. Under the "global option," providers would take on full risk. There is also a "geographic option," in which health systems or insurance plans could assume the risk for the total cost of primary care for a swath of communities within a particular region. Most of the newly announced Innovation Center models will launch in January 2020. The geographic option is projected to begin in mid-2020. (Luthi, 4/22)
CQ HealthBeat:
Medicare Proposal Would Set Flat Monthly Rates For Primary Care
Sen. Lamar Alexander, R-Tenn., chairman of the Senate’s health committee, praised the administration’s emphasis on primary care, which he said influences whether patients need more expensive specialty care or hospital services. "This focus on the nation’s more than 300,000 primary care doctors is the right way to create better experiences, better outcomes and lower costs for patients," he said. (Siddons, 4/22)
