AAFP Agrees With The CMS On Equitable Payment Rules

This one is going to be really interesting. The OPPS or 2019 hospital outpatient prospective payment system (OPPS)  would reduce payment differences between sites of service.  The AAFP feels it would save money for Medicare and patients and improve payment for independent practices. Maybe.

The AAFP encouraged CMS to “create incentives for services to be performed in the most cost-effective location, such as a physician’s office,” and called the differences between inpatient, outpatient and other sites of service an “artificial distinction” that springs from the “equally artificial distinction” between Medicare parts A and B.

You can read the article via the link above.  If the CMS figures a way to not pay hospitals more in their physician outpatient practices (I believe this is the whole “facility fee” scam) then will hospitals unass all the physician offices they own?  Will doctors be free again? Will they flounder billing insurance companies again or go to the light of DPC?

One wonders.  What do you think?

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “AAFP Agrees With The CMS On Equitable Payment Rules

  1. RSW
    September 30, 2018 at 1:30 pm

    More lip-flapping from the AAFP, which is totally in bed with hospital corporations.

    If they ever tell CMS that unless a proposed policy contains payment equality regulations, they will very loudly and publicly oppose it (full page ads, TV spots, etc.) – well, then I might believe them

  2. Michael
    September 30, 2018 at 9:26 am

    If CMS changes even just the E/M payment structure, hospital-based employee primary care will be faced with a significant pay cut. They won’t try to off-load the practices: they’ll just plead poverty, cut salaries, and bet the doctors won’t leave.

  3. September 30, 2018 at 9:00 am

    If I read the CMS OPPS proposed regs
    correctly, the site neutral payment would only apply to E&M codes. If this is true, then I don’t see much impact as far as hospitals shedding physician practices. If the regs do address procedure-based fees/professional fees, then there will be massive offloading of physician practices. I hope for the latter. This would allow for more physicians to start direct pay practices. Both primary care and specialists.

  4. Terry Nugent
    September 30, 2018 at 6:45 am

    Hospitals want to own primary care to lock referrals for all their services in-network. The fee differential is just icing on that cake.

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