Better Health -- NOW Campaign PFS Comment Letter to Urge CMS to Develop MSSP Primary Care Hybrid Payment Option

PCC and its Better Health – NOW campaign plan to recommend a primary care hybrid payment option in its forthcoming comments on the Medicare Part B payment rule. The Campaign’s comments urge CMS to issue a request for information on hybrid payment option within the Medicare Shared Savings Program, as well as alternatives, later this year.
PCC and Better Health-NOW plan to respond to CMS' latest physician payment rule with a call for bold changes to strengthen primary care. The letter, now undergoing final revisions, will praise 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. Primary care practices in Medicare need pathways to rapidly transition from a predominantly fee-for-service model to a predominantly population-based prospective payment (hybrid) model. The BHN Campaign is calling for a primary care hybrid payment option available within the MSSP. The letter recommends 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.

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