Medicare, under the Obama administration, is currently trying evolve into a holistically more efficient solution by changing the way physicians get paid and provide treatment. The Obama administration is trying to recruit as many as 20,000 primary care doctors.
This 5 year program was announced on Monday, and it will be run by the Centers for Medicare and Medicaid services. The aim is to further diversify the methods of providing services to patients, simultaneously cutting costs and to achieve that goal changes must be made to the current method of payment.
The present-day method of payment is based on the number of billable services and visits one makes to Medicare. This method isn’t cost efficient and circumscribes doctors from developing different ways to provide care for people; instead the program will tie payments to overall patient health and outcomes.
CMS will recruit primary care doctors into two payment tracks. The first track will average $15 per beneficiary in addition to the payment the physician receives for the service he provided. The second track will average in $28 per beneficiary and they will receive lower fees for the services provided. The monthly payments for both tracks will be higher for patients with more complex health problems.
According to Dr. Patrick Conway, chief medical officer at CMS the second track of payment will save medicare up to $2 billion over 5 years.
The payments that aren’t used for specific health services will be used by doctor groups to develop different ways of providing health care such as: telephone and video consultations, care managers to help patients with their chronic illnesses, and medications.
This CMS program resembles successful European healthcare payment systems, and according to Conway, “There will be high level of interest across states and regions among primary health care providers.”
By combining itemized fees with flat fees per patient it "really allows them to move away from a visit-based, fee-for-service structure," Conway said on a conference call with reporters. This deviation in payment system is a balance, “Paying for visits at a reasonable rate and then reimbursing substantially for all the other activities necessary to provide care” says Robert Berenson, an individual from the Urban Institute who has written about medical payment systems.
Berenson, however, believes that 20,000 primary care doctors is too ambitious. By starting smaller CMS would be more effective in fixing early stage defects.