May 15, 2024

Cassidy, Whitehouse Introduce Legislation, Release RFI on Primary Care Provider Payment Reform

WASHINGTON – As part of their ongoing work to address primary care challenges and reform physician payment models, U.S. Senators Bill Cassidy, M.D. (R-LA) and Sheldon Whitehouse (D-RI) released a Request for Information (RFI) to accompany the introduction of the senators’ bipartisan Pay PCPs Act, legislation to better support and improve pay for high-quality primary care providers.

“Primary care is a critical part of the health care equation. Overwhelming evidence shows that primary care both improves health outcomes for patients and drives down health costs. There are many issues to address in primary care, and we look forward to receiving feedback on our legislation through the RFI to make a meaningful difference to health care success,” said the senators.

The U.S. spends more on health care as a share of its GDP than peer countries, but U.S. life expectancy is below that of its peer nations—and it is falling. Three in ten people report not having a usual source of primary care, and reports find the U.S. will face a shortage of between 17,000 and 45,000 primary care doctors over the next decade. Cassidy and Whitehouse’s bipartisan legislation aims to head off this expensive primary care shortage while also improving Medicare beneficiaries’ health outcomes and helping primary care providers lower health costs. 

“We at America’s Physician Groups represent roughly 360 organizations committed to providing patient-centered, coordinated health care that is accountable for costs and quality. We can’t achieve this goal without a strong basis in advanced primary care, and outside of value-based payment models, the current structure of Medicare fee-for-service physician payment doesn’t adequately support the model, and in fact, undermines it,” said Susan Dentzer, President and CEO of America’s Physician Groups. “We’re excited to see this new plan for a hybrid form of Medicare payment that will combine prospective, per-member-per-month payments with fee-for-service. This approach will enable many smaller physician practices not only to survive the current headwinds facing primary care, but also to build the infrastructure that they will need to thrive in value-based models – the direction in which the nation’s health care system must continue to move. We also applaud the move to reduce copayments from Medicare beneficiaries for vitally important care coordination services. America’s patients, doctors, and the nation as a whole would be better off with this overall approach, and we look forward to working with policy makers to embed it in law and see it flourish in practice.”

The senators’ accompanying RFI provides stakeholders the opportunity to comment on the bipartisan bill, which serves as a marker for legislation in the primary care space.

Feedback can be submitted to until July 15, 2024.