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Proposed CMS changes would be boon for primary-care clinicians


The Centers for Medicare & Medicaid Services plans to make a renewed push over the next year to boost primary care with new incentive programs.

“In the United States, we have historically invested far more in treating sickness than we do in maintaining health,” CMS acting Administrator Andy Slavitt said in a blog post. “The result of this imbalance is not only poorer health, but more money spent in institutions, hospitals, and nursing homes.”

“The road to a better healthcare system means correcting this imbalance. We should reinvest in what we value — primary care — as a practice, as a profession, and as an abundant resource for patients.”
“Today, we are proposing significant actions to improve how we pay primary-care physicians, mental-health specialists, geriatricians, and other clinicians. By better valuing primary care and care coordination, we help beneficiaries access the services they need to stay well.”

The proposed changes include:

  • Increasing  payments to primary-care providers for routine office visits of  patients with mobility-related disabilities to $119 from $73 a visit.
  • Increasing payments to geriatricians and family physicians. “We anticipate that these clinicians could receive a 2 percent increase in their payments for providing the care we propose to recognize under the Physician Fee Schedule,” Mr. Slavitt said. “Over time, if all of the practitioners that can provide these services provide them to all eligible patients, we estimate that the payment increase could be as much as 30 percent and 37 percent, respectively, to these specialties.”
  • Paying for mental-health care using the Collaborative Care Model, which “supports mental and behavioral health through a team-based coordinated approach involving a psychiatric consultant, a behavioral healthcare manager, and the primary care clinician, and which extends beyond the scope of an office visit,” he said.

To read a longer story in this, please hit this link.

R.I. Blue Cross offers new data and analytics platform


To try to improve care quality and coordination, Blue Cross & Blue Shield of Rhode Island (BCBSRI) will provide primary-care  clinicians with  a new data and analytics platform..

The platform — Blue Insights for Rhode Island — will be available free to all primary-care clinicians in the state.  It  will give providers access to patient-care registries, which BCBSRI says will help them identify care gaps and emerging health concerns among individual patients.

The platform will offer tools to encourage medication adherence, remind patients about scheduling tests or follow-up visits and track patients who have chronic conditions.

The platform’s use of “comprehensive analysis of payer and provider data” will also help providers make informed choices about specialty physicians, facilities and treatments, the insurer said. The next phase of  the Blue Insights platform will be to provide new self-service reporting capabilities for providers.


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