Care management activities such as patient education, risk stratification and care coordination are good for patients--they confirm the value primary care doctors provide to their patients. And it’s certainly welcome news that public and private payers are willing to pay doctors for providing these services.
Where the American Academy of Family Physicians (AAFP) takes issue is the amount payers are currently paying physicians to deliver these services to patients, according to a recent issue brief from the professional association.
According to calculations done by an outside consulting firm, the value of care management services in terms of savings to insurers is $16.73 per member, each month. The outside research firm found that the cost to insurance companies in physician payments for providing these services was just $4.90 per member, each month.
"Family physicians now have some data to make a more informed and intelligent business decision about whether or not they want to accept the care management fees being offered to them by public and private payers and, if not, what they think that fee should be," Kent Moore, the organization’s senior strategist for physician payment, told AAFP News.
The report’s authors encourage physicians and insurance companies to work together to come up with a more appropriate level of payment that reimburses physicians for the time they devote to these services that keep patients healthy.
- read the issue brief (.pdf)