NCQA, 60+ other groups, urge Congress to pass Medicare doc fix supporting PCMH & PCSP

November 14, 2014 · Paul Cotton

NCQA and more than 60 other key stakeholders want Congress to act now on Medicare physician payment reform that provides much-needed support for Patient-Centered Medical Homes and Patient-Centered Specialty Practices.

The legislation, which has broad, bipartisan support, repeals the so-called “sustainable growth rate” formula that now requires huge cuts to physician payments that Congress has repeatedly had to overrule. It would move Medicare further along in its journey to pay not just for volume but the value of care on several fronts. It would:

  • Authorize payments to Patient-Centered Medical Home and Patient-Centered Specialty Practice providers for non-face-to-face chronic care management services that help in preventing costly, avoidable complications.
  • Automatically give PCMH and PCSP providers the highest score for clinical practice improvement activities under a new value-based purchasing program that rewards quality.
  • Provide bonus payments to providers in “Alternative Payment Models” designed to promote better value, for which PCMH and PCSP practices could be platforms.

This support is urgently needed to help PCMHs and PCSPs sustain their transformation to patient-centered, high-value care. NCQA strongly supports these and other provisions in the bill that move Medicare toward paying for value. Please tell your Congressional representatives to support passage of this vital legislation now.

Paul Cotton is the Director of Federal Affairs for the National Committee for Quality Assurance (NCQA)

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