Physician Pay Wars' Winners and Losers

Cheryl Clark, for HealthLeaders Media , November 5, 2012

Primary Care Winners
Among the providers scheduled to receive fee increases, family practitioners top the list with a 7% increase. This which includes a hefty 5% fee increase for providing transitional care management or coordination care services during the 30-days after Medicare patients have discharged from acute care settings or skilled nursing home care. Geriatricians will receive 5%, of which 2% is for transitional care management services.

Nurse practitioners will receive a 4% pay bump, half of which is for transitional care services, while physician assistants will receive a 3% pay increase.

In a statement issued Thursday, CMS said it was trying to recognize "the work of community physicians and practitioners in treating a patient following discharge from a hospital or nursing facility will ensure better continuity of care for these patients and help reduce patient readmissions."

"What Medicare is saying is that they're now recognizing there's a complexity of care that's not been valued in the past," says Jeffrey Cain, MD, president of the 105,000-member American Academy of Family Physicians. "We've had a problem with the culture in our healthcare system (determining) who's in charge of medication, who's in charge of referrals" after a patient is discharged from the hospital.

And this is recognition from CMS for the complexity and value that primary care brings.

Other primary care physicians will also get a pay bump. For internal medicine specialists, the increase is 4%, which includes 3% for transitional care management services. Pediatricians will see 3% more, all of which is for transitional care management.

Providers receiving more pay for transitional care management services may, however, have to hire or contract additional staff to make phone calls, or perhaps even more house calls to check on patients in their nursing homes or residences.

Family doctors will need to be more flexible with their office hours as well. "They'll need to keep slots open in their schedules to be open for access, and have clear lines of communication with their colleagues in the hospital and other members of the patient centered medical home team," Cain says.

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