Pay­ment in­creases planned for pri­mary-care, fam­ily physi­cians

Modern Healthcare - - LATE NEWS -

The CMS in­tends to make a slew of changes to the physi­cian-fee sched­ule for 2013, in­clud­ing a 7% pay­ment in­crease for fam­ily physi­cians and smaller in­creases for other pri­mary-care doc­tors. The pay hike for fam­ily physi­cians comes from a plan to re­im­burse such providers sep­a­rately for pro­vid­ing suc­cess­ful fol­lowup care af­ter a pa­tient’s hos­pi­tal or nurs­ing-home stay, the CMS said. “Help­ing pri­mary-care doc­tors will help im­prove pa­tient care and lower health­care costs long term,” CMS act­ing Ad­min­is­tra­tor Mar­i­lyn Taven­ner said in a news re­lease about the pro­posed rule. The reg­u­la­tions also would make a num­ber of changes re­lated to physi­cian qual­ity re­port­ing. First, the agency pro­vided some clar­i­fi­ca­tion of the physi­cian value-based pay­ment mod­i­fier, which ad­justs pay­ments based on per­for­mance and cost of care. For 2015, the first year that the mod­i­fier will be in use, the CMS pro­posed lim­it­ing its ap­pli­ca­tion to groups with 25 or more physi­cians. Groups that are not par­tic­i­pat­ing in the physi­cian qual­ity re­port­ing sys­tem could opt to set their value-based pay­ment mod­i­fier at a flat 1% re­duc­tion, rather than at a vari­able rate based on qual­ity, the CMS said. The pro­posed rule also in­cludes changes to the CMS’ elec­tronic pre­scrib­ing in­cen­tive pro­gram and its Medi­care elec­tronic health-records in­cen­tive pilot pro­gram.

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