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Transitional Care Payment Policy Can Help Bolster Primary Care

CMS shows interest in developing enhanced pay for primary care practices with medical home model

FRIDAY, Feb. 22 (HealthDay News) -- The Centers for Medicare and Medicaid Services (CMS) have adopted a transitional care payment policy that will increase payment for primary care services and allow further increases if services are delivered efficiently (e.g., using the medical home model), according to a perspective piece published in the Feb. 21 issue of the New England Journal of Medicine.

Noting that the importance of primary care is emphasized in the Affordable Care Act, Andrew B. Bindman, M.D., from the U.S. Department of Health and Human Services in Washington, D.C., and colleagues examined the role of the new transitional care payment code on managing patients' transition back to the community after discharge from a hospital, rehabilitation facility, or skilled nursing facility.

The authors note that, based on the number of discharges per year and physician visits after these discharges, primary care physicians will receive, on average, a 7 percent increase in Medicare payments due to the new payment code. The adoption of the new code indicates CMS's willingness to invest resources in primary care for activities that will offer higher-quality care and lower overall health care costs. CMS also included in the new rule a statement of interest in developing enhanced payment for primary care physicians working in practices that have implemented the medical home model.

"In adopting the transitional care payment policy, CMS has begun shifting more financial resources toward primary care and opened the door to further increases in primary care payment in return for the greater accountability and efficiency that studies suggest may be attained through a medical-home model," the authors write.

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Physician's Briefing