Re: MedPAC discussion on “Rebalancing the physician fee schedule towards primary care
services”
Dear Dr. Mathews:
On behalf of the 20 undersigned organizations, we write to express our concern with the
November 2017 Medicare Payment Advisory Commission (MedPAC) discussion titled,
“Rebalancing the physician fee schedule towards primary care services.” We believe that many
of the underlying assumptions in this November MedPAC meeting presentation are incorrect.
Specifically, we question the problems that MedPAC describes with the way the physician fee
schedule (PFS) pays for primary care, the concerns with income disparities between specialties,
and the effectiveness of increasing payment to certain specialties as a means to address
workforce issues.
Even if MedPAC continues to assert that payment for primary care should be increased, we do
not believe that “rebalancing” of the PFS is appropriate or necessary. Instead, primary care
clinicians should be paid for the value of the care that they provide. It is possible that this could
result in increased payment for primary care. But to suggest that the increase must necessarily
come at the expense of other providers shows a fundamental misunderstanding of the current and
developing workforce shortages for specialties, the reasons that medical students select future
career paths, and a disregard for the stress that has been placed on the entire Medicare system by,
at best, stagnant reimbursements. We discuss these comments in more detail below.
…
Read full letter here
