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Alternative to Medicare Sustained Growth Rate Proposed

Alternative to Medicare Sustained Growth Rate Proposed

Authors suggest Medicare adopt advanced primary care practice as new provider category

THURSDAY, Dec. 26, 2013 (HealthDay News) -- A proposed alternative to the Medicare sustained growth rate (SGR) formula for physicians encourages Medicare to adopt advanced primary care practice (APCP) as a new provider category, according to a perspective piece published online Dec. 18 in the New England Journal of Medicine.

Richard J. Baron, M.D., from the American Board of Internal Medicine in Philadelphia, and Karen Davis, Ph.D., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, propose an alternative to the Medicare SGR formula for physician payment.

Noting that the Senate Finance-House Ways and Means proposal would support a move toward APCP, the authors propose that Medicare adopt it as a new provider category in order to accelerate APCP adoption. The proposed category would provide a bundle of services provided by a team using a technology platform designed to support visit-based and non-visit-based activities. The model would specify practice capacities and incorporate a payment model offering care management fees that flow predictably. Creation of a new provider category would provide multiple tools for policymakers to accelerate enhanced primary care availability; accelerate care team deployment; and foster development of the information infrastructure for delivering patient-centered, coordinated primary care.

"We believe that the combination of Medicare payment reform for APCPs and financial incentives for beneficiaries to seek this form of high-value care would induce most primary care providers to embrace practice transformation to ensure the best possible patient outcomes and experiences," the authors write.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1314933?query=featured_home )