In July, CMS made important new proposals to improve how primary care providers are paid to care for Medicare beneficiaries. If finalized in the 2025 Physician Fee Schedule Final Rule later this year, these proposals (known as the Advanced Primary Care Management bundle) will add new reimbursement opportunities for the delivery of comprehensive primary care, including care management outside visits. These proposals are best understood as part of a broader arc of payment reform in Medicare Part B, which over the last several years has phased in standalone payments for critical aspects of primary care and population health – filling longstanding reimbursement gaps that have traditionally threaten the primary care sector’s ability to grow and adapt to meet the needs of American seniors in the 21st century. As CMS explains in the proposals, these changes have been greatly informed by smaller-scale tests of change conducted by the CMS Innovation Center in the years since the Affordable Care Act. These proposals are of importance to all payers, including state Medicaid programs; as well as provider organizations and all with an interest in improving population health.
CMS seeks feedback on these proposals, including through a detailed “Advanced Primary Care RFI” for which responses are due September 9.
Manatt was joined for this session by CMS to discuss the proposals and RFI, including the broader implications of these changes beyond Medicare.
Speakers
- Jared Augenstein, Managing Director, Manatt Health
- Tracy Johnson, Managing Director, Manatt Health
- Edith Coakley Stowe, Managing Director, Manatt Health
- Christiane LaBonte, Senior Advisor, Center for Medicare
- Sarah Irie, Division of Practitioner Services, Center for Medicare
- Carmen Cummings, Division of Advanced Primary Care, Center for Medicare & Medicaid Innovation
Date and Time
Wednesday, August 28
10:00 a.m. – 11:00 a.m. PST
1:00 p.m. – 2:00 p.m. EST
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This program does not constitute legal advice, nor does it establish an attorney-client relationship. Views expressed by presenters are strictly their own and should not be construed to be the views of Manatt or attributed to Manatt.