Courtney, Rouzer Lead Letter to HHS In Support of New Primary Care Payment Model
(Washington, D.C.) – Today, Rep. Joe Courtney (CT-02) and Rep. David Rouzer (NC-07), co-chairs of the Congressional Primary Care Caucus, led a group of bipartisan members in writing to Health and Human Services (HHS) Secretary Alex Azar to ask for swift consideration of the Advanced Primary Care Alternative Payment Model (APC-APM), a new model for primary care payment that requires the Secretary’s approval before implementation among Medicare providers can begin.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) which created a roadmap for transitioning Medicare providers from providing ‘high-volume’ services, to ‘high-value’ services. This roadmap consists of two paths for providers; one called the Alternative Payment Model (APM) and one called the Merit-Based Incentive Program. For providers to participate in the APM track, these models must be approved by the Secretary. The APC-APM is one model, developed by the American Association of Family Physicians, designed to improve the way Medicare pays for primary care and how patients receive care. It includes a per-member monthly payment to physicians to cover population health and in-person visits, and additional payments to cover email and phone consultations. This flexible model is designed to reduce the administrative burden associated with reporting and billing to focus more resources on patient care.
“We believe that the APC-APM proposal is consistent with the Administration’s goals of preserving independent medical practices, lowering the cost of health care, and reducing the administrative burden for physicians and other health care providers,” wrote the members. “If fully implemented, the APC-APM would allow more than 200,000 primary care physicians to engage in a payment model that promotes the value of primary care through comprehensive and continuous patient-centered primary care.”
Michael Munger, MD, president of the American Academy of Family Physicians, said “The AAFP’s APC-APM is the first payment model founded on primary care to be approved by the Physician-Focused Payment Model Technical Advisory Committee (PTAC). It is a foundational element in the movement to value-based care, as envisioned under MACRA, because it is designed to expand primary care physicians’ access to APMs—including small, independent and rural practices—and it’s designed with a standard of patient choice. We appreciate and welcome the support of the Primary Care Caucus and its leaders Reps. Joe Courtney and David Rouzer.”
The APC-APM has been approved by the MACRA-created Physician-Focused Payment Model Technical Advisory Committee (PTAC), which recommended pilot implementation of the model. Secretary Azar must approve the proposal before this testing can begin. Since the law’s passage, only one APM has been approved.
The full letter is below and available online
May 14, 2018
The Honorable Alex Azar
Department of Health & Human Services
200 Independence Avenue, SW
As members of the Congressional Primary Care Caucus, we write to respectfully request your full and fair consideration of the Advanced Primary Care Alternative Payment Model (APC-APM), a proposal that is currently pending your review.
In 2015, the United States Congress passed and the President enacted, the Medicare Access and CHIP Reauthorization Act (MACRA) (P.L. 114-10). This law aimed to improve the quality and efficiency of health care. A key component of MACRA was the emphasis the law placed on moving a greater percentage of physicians and other health care providers into alternative payment models (APMs). To facilitate the development, testing, and implementation of alternative payment models, Congress established the Physician-Focused Payment Model Technical Advisory Committee (PTAC).
On December 19, 2017, the PTAC approved the Advanced Primary Care Alternative Payment Model for limited testing. The next step in the process calls for the Secretary of Health and Human Services to review and act on the recommendation from the PTAC. We urge a timely review of this important and thoughtful proposal.
For your background, the APC-APM is a comprehensive primary care delivery system and payment reform proposal, developed by the American Academy of Family Physicians (AAFP) and supported by numerous primary care and health care organizations. The proposal promotes advanced primary care as foundational to our health care system while also taking significant steps to reduce the complexity for physicians allowing them to focus on providing care to their patients.
We believe that the APC-APM proposal is consistent with the Administration’s goals of preserving independent medical practices, lowering the cost of health care, and reducing the administrative burden for physicians and other health care providers. If fully implemented, the APC-APM would allow more than 200,000 primary care physicians to engage in a payment model that promotes the value of primary care through comprehensive and continuous patient-centered primary care.
Preserving and promoting comprehensive, continuous, and patient-centered primary are is a goal we all share. We believe the APC-APM could be an important step towards achieving this mutual goal. Therefore, we are pleased to lend our support to the proposal and its further testing, as recommended by the PTAC.
Mr. Secretary, thank you for the opportunity to share these views with you. Please contact Jason Cooke in Representative David Rouzer’s office or Maria Costigan in Representative Joe Courtney’s office for additional information on the Primary Care Caucus or this recommendation.
Rep. Joe Courtney
Rep. David Rouzer
Rep. John B. Larson
Rep. Steve Stivers
Rep. Niki Tsongas
Rep. Roger W. Marshall
Rep. Rosa DeLauro
Rep. George Holding
Rep. James A. Himes
Rep. Lynn Jenkins
Rep. Blaine Luetkemeyer
Rep. James P. McGovern
Rep. Elizabeth H. Esty
CC: The Honorable Seema Verma, Administrator, Centers for Medicare & Medicaid Services