Is Fee-for-Service Compatible with Comprehensive Primary Care?

The Primary Care Collaborative held a webinar exploring whether primary care can meet patients’ increasingly complex needs under fee for service — and what steps policymakers must take to ensure access to high-quality primary care.

In a recent Senate hearing, Dr. Amol Navathe noted that “the status quo fee-for-service system is a key factor in producing [care] fragmentation” and called for providing primary care practices steady monthly pay in addition to certain fee-for-service payments to “unshackle” practices from a system that requires billing for every task. He observed that more well-intended billing codes are producing more administrative complexity and costs, and the codes are consequently underutilized. New research on Medicare transitional care and chronic care codes confirms that many beneficiaries who could benefit from these services are not receiving them.

This webinar convened leading primary care practitioners, practice enabler organizations, and policy experts, including from AARP, together to discuss how we ensure that all of Medicare—traditional Medicare, Medicare alternative payment models such as ACOs, and Medicare Advantage—all promote coordinated, comprehensive primary care.

Resources

• What to know About How Medicare Pays Physicians - Kaiser Family Foundation
• Medicare Stumbles Managing a Costly Problem—Chronic Illness - KFF Health News
• Dr. Navathe’s and Melanie Matthews’ testimony before the Senate Finance Committee, April 11, 2024
• Medicare Physician Fee Schedule Reform: Structural Topics and Recommendations to Strengthen the System for the Future - HMA