The AHA July 15 commented to Sens. Sheldon Whitehouse, D-R.I., and Bill Cassidy, R-La., responding to a request for information based on the Pay PCPs Act, legislation designed to improve support and pay for primary care providers. The AHA expressed concerns that its proposed hybrid per-member-per-month and fee-for-service payment structure in the physician fee schedule for primary care could result in payment cuts, and that there may be variation in the PMPM depending on the type of provider. The bill also has language implying that there is latitude for the PMPM to not be risk-adjusted and possibly restrict what could be included in the risk adjustment, AHA said. 

The AHA voiced support for a provision in the legislation that would reduce beneficiary cost-sharing for primary care services by 50% under the hybrid payment model. The association also shared principles for Congress to consider when designing alternative payment models to make participation more attractive for potential participants.
 

Related News Articles

Headline
Dan Peterson, CEO of behavioral health services at Sutter Health, and Matthew White, M.D., chair of the behavioral health service line at Sutter Health, share…
Headline
AHA Executive Vice President Michelle Hood previews the AHA Rural Health Care Leadership Conference — one of the AHA’s flagship events — which will be held Feb…
Blog
Public
The 39th Annual AHA Rural Health Care Leadership Conference will be held Feb. 8-11 in San Antonio, Texas. The conference brings together senior executives…
Headline
The AHA Nov. 17 released Fast Facts: Is My Hospital Rural, featuring updated information on the important role rural hospitals play in their communities, the…
Headline
The Medicare Part A deductible for inpatient hospital services will increase by $60 in calendar year 2026 to $1,736, the Centers for Medicare & Medicaid…
Headline
The Centers for Medicare & Medicaid Services Nov. 14 released preliminary guidance to states on implementing provider tax provisions in the One Big…