Primary Care Valuation
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Primary Care Valuation

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  • Expect a push back about the cost - just tell them this is probably the best time - it'll only go higher. The public health trust fund, PCORI and insurance exchanges are places they have gone for offsets.

Primary Care Valuation Primary Care Valuation Presentation Transcript

  • The Value of Primary CareFamily Medicine Asks:• Repeal the SGR• Specify 5 years of payments (with a higherrate for primary care)• Make permanent Medicare and Medicaidincentives for primary care
  • • Repeal the SGR (background)o Bipartisan agreement: the SGR must go.o CBO estimate of cost (which may be revisedtoday – May 14) is $138 billion/10 yearso How to pay for repeal is the hard part:• Use repeal of the Affordable Care Act (ACA)?• Require pharma to negotiate Part D drug prices?• GOP: no new taxes; Dems: no higher beneficiarycosts.
  • • Our position on how to pay for this fix?That’s up to Congress.• Don’t engage in the discussion on budgetoffsets– It’s too political– Family Medicine doesn’t have policy• Focus on your experience with theinstability created by short-term patches.
  • • Repeal the SGR (business argument)o We all want to move health care delivery to avalue-based, patient-centered system.o This requires investments in H.I.T., qualityimprovement and staff development/training.o These investments are impossible in anenvironment of uncertain payment.o Tell your story here.
  • • Specify 5 years of payments (with ahigher rate for primary care)o Physicians need a period of stability to make theinvestments to evaluate and adopt new paymentmodels (e.g., PCMH, ACO) – Tell your story hereo It’s in Congress’s interest: Stronger primary care isessential for better quality and more efficiencyo We need a higher payment rate for primary care tokeep pc physicians and attract students with largedebt of educational loans
  • • Make permanent Medicare and Medicaidincentives for primary care• Medicare pays a p.c. doctor or provider 10%more for office visits – but only through 2015.• Medicaid pays a p.c. doctor at least whatMedicare pays for office visits andimmunizations – but only through 2014.• These are clear signals that primary carematters for quality and efficiency.
  • • Political Realities– GOP legislators want to focus on reducedhealth care spending.– Democratic legislators want to focus on betterhealth care delivery, improved services formore people.– Fortunately, the key to achieving both goals isinvestment in primary care.
  • The Value of Primary CareFamily Medicine Asks:• Repeal the SGR• Specify 5 years of payments (with a higherrate for primary care)• Make permanent Medicare and Medicaidincentives for primary care