An important step to not only reward those currently delivering primary care but also help make the field of primary care more attractive, is to pay providers more for the delivery of primary care services. There is near universal agreement on Capitol Hill that we must increase reimbursement rates for services provided by primary care specialties. Proposals from the Medicare Payment Advisory Commission and provisions included in reform legislation being developed in both the House and the Senate would increase the reimbursement rate for many primary care services, including office visits, by 5 to 10 percent.
Other proposals include more innovative ways to pay primary care clinicians better that would simultaneously change the way care is delivered and improve patient outcomes. Primary care clinicians are often frustrated with the current fee-for-service reimbursement method that pays for each individual service or procedure, and usually reimburses more technical elements at high levels while giving short shrift to primary care services.
Paying primary care providers for improved patient outcomes rather than just fee-for-service also encourages a more collaborative approach to care delivery. Instead of having to monitor every individual service provided, primary care clinicians could function more as “team leaders” providing oversight in the overall goal to make patients healthier. This would then free some of their time and allow them to provide broader care to more patients. It would also maximize the role of many different members of the health care delivery team, including nurses, care coordinators, medical assistants, and even lay home workers; ultimately extending the reach of those primary care providers. Both the House and the Senate health reform proposals include these and additional new models to pay for health care delivery.
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