PCC and Better Health--Now Responds to Medicare Physician Fee Schedule Proposed Rule

PCC Advocates for a Hybrid Payment Option Within the Medicare Shared Savings Program

On September 5, PCC and Better Health-NOW responded to CMS’ latest physician payment rule with a call for big policy change to strengthen primary care. The letter praised constructive CMS proposals to strengthen behavioral health integration, vaccination reimbursement, and access to accountable care in underserved communities, but insisted that the agency must move much more boldly to support whole person primary care in all communities
Medicare Part B’s reliance on fee-based payment as the primary means of primary care payment systematically undercuts investment in the sector even as it undermines health equity. Yet to date, Medicare, the nation’s largest payer, has yet to implement widely available alternatives to the fee-for-service reimbursement in primary care. The PCC/BHN letter argued that primary care practices need pathways to rapidly transition from a predominantly fee-for-service model to a predominantly population-based prospective payment (hybrid) model. The BHN Campaign specifically called for a primary care hybrid payment option available within the MSSP and suggested that CMS seek public input to inform the design and implementation of such an option, as well as other possible pathways to support population-based, prospective payment in Medicare.

Read the full letter here

PDF icon PCC Comments_CY23PFS_NPRM_FINAL.pdf340.3 KB
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