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CMS Pays Primary Care Bonuses Amidst Bureaucracy

Joe Cantlupe, for HealthLeaders Media, August 19, 2013

Internal medicine physicians were paid 49.4% of MPCIP funds, followed by 37.9% of family physicians. Others included nurse practitioners; 7.5%; physicians' assistants 2.9%; geriatrics, 1.9%; and clinical nurse practitioners, .2%, according to CMS. The agency reported that MPCIP funds were allotted to 80% of physicians in urban areas, and 20% in rural. Incentive payments equal 10% of the Medicare paid for primary care services.

Cain did not disclose how many members of the 100,000-member AAFP have applied for the funds, but said his organization "is helping our members understand they have to be proactive" in receiving payment. "We are helping members through the process," he says.

"The number of folks who qualify (annually) is pretty stable, but we want to make sure they are part of this program. One of the things family doctors complain about is the number of hoops and hassles in Medicare and Medicaid," Cain says. The number of physicians enrolled was unavailable.

"We have to be careful as we improve payment (structures); we are not increasing the hassle factor." The AAFP is "encouraging (the government) to simplify procedures," he says.

The Medicare payment plan is authorized under the Affordable Care Act. Eligible practitioners are eligible for the payments if primary care services accounted for at least 60% of the practitioner's total allowed charges under the physician fee schedule in the qualifying calendar year. The payments are made quarterly.

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