CMS to pay primary-care docs for complex services outside office visits

The CMS is moving forward with a proposal to pay primary-care physicians for complex chronic-care management services provided outside of face-to-face office visits.

Physician groups have long asked to be reimbursed for services such as modifying care plans and coordinating care with clinicians in other practices, and they cheered when the policy was included in a final rule on physician pay posted Nov. 27. It's set to begin in 2015.

“We believe that successful efforts to improve chronic-care management for these patients could improve the quality of care while simultaneously decreasing costs, through reductions in hospitalizations, use of post-acute care services and emergency department visits,” Jonathan Blum, principal deputy administrator at the CMS, said in a statement.

Overall, the CMS projects that total payments under the fee schedule in 2014 will be approximately $87 billion, up from $80 billion in 2012. The American Medical Association said it hopes the payment rule “serves as an urgent reminder to Congress that there are just 34 days before physicians who care for Medicare patients will face a steep payment cut of about 24% due to the short-sighted, fatally flawed Medicare payment formula—the SGR.”

The Senate Finance Committee has scheduled an executive session for Dec. 12 to discuss a bipartisan proposal to overhaul the payment formula.

Follow Virgil Dickson on Twitter: @MHvdickson