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News & Analysis of Medicare beneficiaries. Although Pri- services based on these codes because they clinicians, that diminish the large dispari- mary Care First would provide primary care perceive that the size of the investment they ties in payment between primary care and clinicians some flexibility in how they could would need to make in their practice to do specialist physicians, that eliminate finan- align their effort with patients’ needs, it so is too great, given the current reimburse- cial barriers such as co-payments for the use would not rectify the long-standing issue of ment rate structure in primary care. of primary care services, and that provide re- underpayment to primary care clinicians. CMS also discourages primary care by sources and incentives for primary care cli- The proposal is essentially cost neutral for charging Medicare beneficiaries the same nicians to furnish population-based care. primary care practitioners compared with 20% co-payment for primary care that it A commitment to universal health care cov- the current fee-for-service payment ap- charges for most other services. The ACA re- erage is fundamental to creating a just and proach, and there is concern that as a result moved this co-payment for preventive care equitable
JAMA – American Medical Association
Published: Nov 5, 2019
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