Improving Primary Care Valuation Processes to Inform the Physician Fee Schedule

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Describes the current process and data inputs used by the Centers for Medicare & Medicaid Services (CMS) for primary care service valuation in the Medicare Physician Fee Schedule (PFS). Discusses promising approaches to update the PFS and the potential role of hybrid payments. Offers recommendations to CMS to improve the valuation process and accurately reflect the full scope of high-quality primary care.

2025

Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine

Healthcare business and finance · Medicare · Policy · Primary care · Reimbursement and payment models