CMS proposes pay bump for community physicians, care coordination

With the update to the Medicare Physician Fee Schedule (MPFS), family physicians could get a 7 percent pay bump, while other primary care practitioners could see reimbursement increases between 3 percent and 5 percent, the Centers for Medicare & Medicaid Services announced Friday. The announcement follows the agency's proposed rule issued July 6, in which primary care physicians could see a potential raise in 2013.

In addition, CMS proposes to pay physicians a separate fee to coordinate care for 30 days following a patient's discharge from a hospital or nursing facility. According to CMS, this is the first time it has proposed payment explicitly for care related to a patient's transition back to the community after an inpatient stay. As part of its public comment process, CMS also is soliciting feedback on how it can better recognize the care coordination work done by community physicians.

However, to offset these increases, CMS is looking to keep some specialists' pay flat and decrease others'. For instance, radiation oncologists would face a cut of roughly 15 percent, Medscape Today reported. In addition, anesthesiology, cardiology and vascular surgery are among specialties facing a 3 percent reduction.

While, by law, CMS' projections include a 27 percent reduction in pay as called for by the sustainable growth rate, it is likely Congress will avert the cut--as it has in years past--while legislators work on a permanent solution.

The current proposed rule also calls for a number of changes to its health IT incentive programs, including the electronic-prescribing incentive program, the Physician Quality Reporting System (PQRS) and the Physician Compare website. Changes include new "hardship" provisions to the e-prescribing initiative and plans to post PQRS data supplied by group practices on Physician Compare in 2014.

CMS invites public comment on the proposed changes until Sept. 4, with a final rule to be issued by Nov. 1.

To learn more:
- read CMS' proposed rule (.pdf)
- see the statement from CMS
- read the story from MedPage Today
- see the article from Medscape Today
- see the post from Lexology (registration required)