Improving Primary Care Valuation Processes to Inform the Physician Fee Schedule

By: Board on Health Care Services and National Academies of Sciences, Engineering, and Medicine and Health and Medicine Division and Committee on Improving Primary Care Valuation Decisions for the Physician Fee Schedule by the Center for Medicare

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Synopsis: In 2024, the National Academies of Sciences, Engineering, and Medicine were tasked with convening a committee to examine the current process and data inputs used by the Centers for Medicare and Medicaid Services (CMS) to valuate primary care in the Physician Fee Schedule. Additionally, the committee was tasked with outlining alternative methodologies for data collection and potential sources of input to more accurately capture the time, intensity, and complexity of the work required to deliver high-quality primary care. The resulting report, Improving Primary Care Valuation Decisions for the Physician Fee Schedule by the Center for Medicare, makes specific recommendations for CMS to address the systemic flaws currently affecting primary care professionals and limiting the potential of high-quality primary care services for all.