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Proposed Medicare physician fee schedule update ‘a great foundation’ – ACP


 

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First impressions of the Centers for Medicare & Medicaid Services’ proposed updated to the physician fee schedule for 2017 are positive, according to the American College of Physicians.

“We think it’s a great foundation,” Robert B. Doherty, ACP senior vice president of government affairs and public policy, said in an interview.

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The proposed update, published July 15 in the Federal Register, brings in a number of new policies aimed at improving physician payment for caring for patients with multiple chronic conditions; mental and behavioral health issues; and cognitive impairment or mobility-related issues.

Among the provisions in the 800+-page proposal, are revised billing codes that would more accurately recognize the work of primary care and other cognitive specialties. The changes, according to CMS, will help “better identify and value primary care, care management, and cognitive services.” Comments on the proposed rule are due Sept. 6, 2016.

The agency is proposing a number of coding changes that “could improve health care delivery for all types of services holding the most promise for healthier people and smarter spending, and advance our health equity goals,” according to a CMS fact sheet.

The proposed fee schedule also would update how quality is measured and reported by accountable care organizations in the Medicare Shared Savings Program; align Accountable Care Organization reporting with the Physician Quality Reporting System; and change how beneficiaries are assigned to an ACO. Potentially misvalued services also would continue to be reviewed under the proposal.

Robert B. Doherty

Robert B. Doherty

“We think this is a big step forward,” Mr. Doherty said. “There is a lot in this proposed rule to strengthen primary care and particularly to reduce barriers to the ability of primary care physicians to take care of patients with chronic illnesses and patients who have mental or behavioral health conditions.”

“There are a number of specific provisions we are very happy to see in the proposed rule, including improvements in the existing codes for chronic care management, creating new codes for more complex chronic care management, simplifying the billing for those codes, creating reimbursement for a team-based primary and behavioral health care services, expansion of a program to help prevent diabetes and patients who are at high risk of developing diabetes and a whole host of other things,” he continued, adding that upon first inspection, there was nothing that stood out as being a proposal that they were not happy with, though he expects when ACP staff drills deeper into the details, the organization will make recommendations to better strengthen the overall proposal.

The agency is also proposing a code to allow for the payment of advanced care planning services furnished via telehealth.

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