"We often think of ambulatory care and the clinics providing primary care. That is certainly true, but in addition, our members have specialty clinics that often act as a medical home for those complex patient populations. For example, most of our members will have a cardiovascular clinic, a diabetic clinic, a pain clinic, cancer clinics, and the patients that we serve really don't have any other source of care to manage those really complex medical conditions."
Feldpush says capping outpatient reimbursements doesn't meld with the integrated care model that the federal government is advocating.
"As we think of moving to integrated care, providing better care in the ambulatory setting to keep people out of the hospital, reaching out to folks who don't have good access now, this proposal seems to fly in the face of that," she says.
"This proposal contradicts the agreed upon goals we are all working for, integrated care and providing care in the least-resources-intensive setting for the benefit of patients."