Hybrid Medicare Payments for Primary Care Providers and Reduced Patient Costs
This Act establishes a new hybrid payment system under Medicare for primary care providers, combining fixed monthly payments per patient with traditional fee-for-service payments. This change aims to improve the quality of care, especially for beneficiaries with chronic conditions, by better funding essential activities like care management and patient communication, which are currently underpaid. Furthermore, beneficiaries who designate a primary care provider may see their out-of-pocket costs (cost-sharing) for these services reduced by 50%.
Key points
Introduction of hybrid payments (fixed monthly fee plus fee-for-service) for primary care providers in Medicare to better fund comprehensive care.
Potential 50% reduction in beneficiary cost-sharing for primary care services if the beneficiary designates a primary care provider as their usual source of care.
The new system aims to properly value services currently poorly compensated, such as care management, communication (emails, calls), and behavioral health integration.
Establishment of a new technical advisory committee to help accurately determine the relative value of medical services under Medicare, addressing pricing distortions.
Expired
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