AAFP desire to boost payment may face opposition
With a national focus on chopping healthcare spending and a new study blaming physician fees for the high cost of U.S. healthcare, the American Academy of Family Physicians may have a tough time advancing its effort to boost payment for primary care.
In an Aug. 29 letter to the CMS commenting on the proposed Medicare physician-fee schedule for 2012, the AAFP requested a more timely review of “misvalued” primary-care services and also proposed seeking payment for telephone calls and online medical evaluations.
The AAFP also recently launched a 22member task force to review and “more appropriately appraise” primary-care services—particularly patient evaluation and management. The Primary Care Valuation Task Force is seen as a counterbalance to the American Medical Association’s Specialty Society Relative Value Scale Update Committee, also known as RUC, which gives payment advice to the CMS and which critics say assigns more value to procedures performed by specialists over “cognitive services” provided by primary-care physicians.
The AAFP sent a letter to RUC Chairwoman Dr. Barbara Levy recommending several changes to the panel which, according to the AAFP, were necessary in order for the RUC “to remain a credible entity” in its role as a CMS payment adviser. These changes included eliminating three seats reserved for a rotating set of subspecialty representatives; adding four seats for representatives from the AAFP, American Academy of Pediatrics, American College of Physicians and American Osteopathic Association; adding three “external” seats for representation by consumers, employers, health systems or health plans; and adding a seat for geriatrics.
“There is an evolving amount of data appearing in the literature that suggests the complexity of evaluation and management services provided by primary-care physicians today is different and likely more ‘intense’ than the same services provided by other specialties,” Dr. Lori Heim, AAFP board chairwoman, wrote in the June 10 letter to Levy.
Chaired by Heim, the AAFP task force includes representatives from the AAP, ACP, AOA, Cigna Healthcare, the National Business Group on Health, and others. It held its first meeting Aug. 22.
Task force members “recognized that primary care has been undervalued, that the primary-care workforce depends on appropriate payment for their services, and that we’re facing a crisis in the primary-care workforce,” Heim said in a prepared statement after the meeting. An AAFP representative was not available for comment.