29 July 2013

Will Doctors Earn New Chronic Care Fee?

The Centers for Medicare & Medicaid Services (CMS) may think they are doing primary care physicians a good thing; however, only a few days after their announcement there is squabbling among the professional organizations and concern about making it easier to get the money. I think it is time to take them out behind the woodshed and give them the what for when they whine so much.

Shari Erickson, vice president of governmental and regulatory affairs at the American College of Physicians (ACP), wants to make it too easy for physicians to obtain the chronic care fee and do almost nothing to earn it. To me it sounds like she is saying they have it coming. This is not the intent and fees should be earned, Ms. Erickson. “Erickson said that the ACP prefers that official designation as a medical home does not become a prerequisite. That way, physicians who lack this designation still have a "nice pathway" toward payment models beyond traditional fee-for-service.” Bold is my emphasis.

Jeffrey Cain, MD, president of the American Academy of Family Physicians (AAFP), said the new fee is part of the evolution toward a payment system that recognizes that "patient care requires more than face-to-face time."”

At least Dr. Cain accepts the “medical-home” status for earning the fee and clearly states that it should not be the sole criterion for earning the fee. He states, “The rationale for the proposed management fee jibes with the medical home.”

Both Erickson and Dr. Cain said their societies are still digesting the details of the CMS proposal. The proposed CMS regulations on the new fee are scheduled for official publication in the Federal Register on July 19. CMS will accept comments on them until September 6 and then issue a final version of the regulations on or near November 1. The proposed regulations explain how the public can submit comments.

The link above downloads a lengthy PDF file (over 580 pages) and reading is time consuming, but interesting.  I will be reading the publication in the Federal Register before making my own comments about the Chronic Care Fee.

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