UC Expert Joins National Primary Care Valuation Task Force

Although primary care is the backbone of all health care needs, the physicians who provide these services often get overlooked in many aspects of the field, including payment from insurance and government agencies and incentives for effective performance.

And it’s not a one-size-fits-all situation that can apply the same evaluation processes to both primary care and specialty services.

To help resolve this, the American Academy of Family Physicians (AAFP) has formed a new Primary Care Valuation Task Force to review the methods for valuing health care services and making recommendations about more accurately valuing and paying for primary care physician services.

Twenty-one leaders throughout the country with health care system and policy expertise have been asked to join the task force. Ronnie Horner, PhD, chair of the department of public health sciences at UC, is one of them.

"I’m honored to be part of this extremely important initiative,” he says. "This has potential to improve the delivery of primary health care as well as impact quality of care and satisfaction for both patients and physicians nationwide.”

At an inaugural meeting in Washington, D.C., Monday, Aug. 22, the task force will begin a six- to nine-month project to identify ways to appropriately appraise evaluation and management services provided to patients.

Horner says in his experience, he has seen a bias toward procedures and not primary care and prevention.

 "The right care delivered at the right time can prevent the need for more costly health care in the future,” he says. "However, because these are avoided costs—costs never experienced—neither the patient nor society fully appreciate the value of the health care that kept them healthier.”

The new task force will focus its attention on alternative payment methods that could work within the current fee-for-service model. Additionally, other data sets will be used with hopes of revealing more appropriate ways to value all physician services, including those delivered by primary care physicians.

The task force will present its findings to the AAFP Board during the first quarter of 2012 and will then present the recommendations directly to the Centers for Medicare and Medicaid Services for its consideration in assessing the appropriate work relative value units that measure the worth of a service and determine Medicare fee-for-service payment to primary care physicians.

"The lower value assigned to primary care services results in lower salaries for primary care physicians, which in turn has been identified as a major factor in the decline in number of this type of doctor,” Horner says. "If a higher value can be established as more appropriate, this will entice a greater number of new doctors to enter the primary care specialties and help keep current primary care doctors in practice. The bottom line: Patients will have greater access to primary care.”