AAFP sends alternative payment proposal to HHS

The AAFP has submitted an alternative payment proposal to HHS that it says makes primary care patient-centered and is “comprehensive, continuous, coordinated, connected and accessible from the patient’s first contact with the health system,” according to a statement.

The group said its plan, if adopted, also focuses on physicians, reduces costs and ensures more Medicare beneficiaries would have access to health care.

AAFP said it was prompted to send in the suggestion after HHS’ newly formed Physician-Focused Payment Model Technical Advisory Committee sent out a request for proposals.

“Longstanding inequities in payment have had a particularly negative impact on primary care ... these wrongs must be addressed and corrected rather than blindly incorporated into new value-based payment models,” AAFP’s statement read.

Components of the plan include:

•quarterly prospective, performance-based incentive payments related to patient experience, clinical quality and utilization measures;

•fee-for-service payments that cover only services not included in the global payment;

•monthly prospective, population-based payments covering non-face-to-face patient services; and

•monthly prospective, risk-adjusted primary care global payments for direct patient care.

AAFP estimated that if its proposal is adopted, the plan would be available to all physicians with primary care specialty designations: general internal and pediatric medicines, geriatric medicine, general practice and family medicine.

The group also stated that its plan meets the Physician-Focused Payment Model Technical Advisory Committee criteria, such as integration and care coordination, payment methodology, and quality and cost. The proposal also follows its own Joint Principles of the Patient-Centered Medical Home, which provide:

•comprehensiveness and coordination;

•patient and caregiver engagement;

•care management;

•planned care and population health; and

•access and continuity of care.

“These five key functions would drive success when implemented along with other equally important pieces such as enhanced payment, continuous data-driven quality improvement, health information technology, and a certified electronic health record that includes either a data registry or repository capability,” the statement read.

AAFP encouraged HHS to act quickly on its request.

"We request that the [Physician-Focused Payment Model Technical Advisory Committee] review the model, provide feedback to the AAFP on it, and promptly recommend it to HHS for approval and nationwide expansion.”