Providers, Execs Applaud Medicare’s Primary Cares Initiative April 24, 2019

Provider groups and healthcare executives are on board with Medicare’s new Primary Cares Initiative, which will shift primary care from fee-for-service to value-based reimbursement models starting in 2020.

“Providing adequate financial support for high quality primary care must be an essential element of any strategy to improve the quality and affordability of our country’s healthcare system,” said Gerald E. Harmon, M.D., immediate past chair of the American Medical Association Board of Trustees.

Provider groups are especially excited about the initiative’s Primary Care First (PCF) track, which includes two value-based reimbursement models for primary care providers.

“Primary Care First is a smart step in the right direction, further moving healthcare away from fee-for-service and toward paying for better health outcomes,” said Aledade Vice President for Policy and ACO Administration Travis Broome. “Today’s announcement shows that Secretary Azar and Administrator Verma recognize the leading role that primary care physicians play in a value-based healthcare system that better serves patients, providers, and payers alike.”

Primary Care First is a set of voluntary five-year payment model options. All five reward providers for delivering high-quality care at lower costs. The regionally based track supporting multiple payers will pay primary care practices a population-based payment, plus a flat primary care visit fee to encourage providers to deliver value-based care.

Certain practices will also get higher payments for treating patients with complex health problems such as chronic or severe illnesses.

While some medical organizations were excited about the emphasis on primary care patients, the Coalition to Transform Advanced Care (C-TAC) also expressed enthusiasm for the payment model that rewards primary care providers for delivering high-value care to patients with chronic or severe illnesses.

“This model will be a critical component in the continuum of care and we are eager to focus our expertise and resources on bringing that continuum to life,” said C-TAC Co-chair and Co-founder Tom Koutsoumpas.

The American Academy of Family Physicians also appreciated CMS’s commitment to investing in primary care. Currently, primary care represents as little as 2 percent of total Medicare spending.

Some industry experts and leaders are waiting for more details, hoping to see more information about the new payment models and how they can support efforts to improve the health and well-being of patients and communities.

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