The Centers for Medicare and Medicaid Services announced changes Wednesday that would alter how Medicare pays for primary care, care coordination and mental health care, resulting in an estimated $140 million in additional funding in 2017 to physicians and practitioners providing those services.
Over time, if qualified clinicians fully provided those eligible beneficiaries, CMS expects the increase could amount to $4 billion or more in additional support for care coordination and patient-centered care.
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Within the framework of those final primary care payment policies, clinicians will also be able to bill, and be paid, more appropriately when they spend more time with their patients. It's a move the federal agency said will encourage collaboration among physicians to provide more personalized care.
"Geriatricians, internists, and family physicians provide core services for the Medicare program, including the kinds of care management and patient-centered care that are described by these new codes," wrote CMS on its blog. "Over time, we estimate that the payment increases attributable to these new codes could be as much as 30 and 37 percent respectively to these specialties."
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CMS is also finalizing new coding and payment using the Psychiatric Collaborative Care Model, which supports mental and behavioral health through a team-based approach -- involving a psychiatric consultant, a behavioral healthcare manager and the primacy care provider. The model, which CMS said "extends the scope" of a typical office visit, seeks to address the challenge inherent in seeking access to behavioral and mental healthcare.
The agency also expanded its Medicare Diabetes Prevention Program, with the revamped program slated to kick off in 2018. The test model identified people who were at high risk for developing type 2 diabetes and provided them strategies for increasingly their physical activity and controlling their weight; CMS said the test led to an approximately 5 percent reduction in weight and saved Medicare about $2,650 for each person enrolled in the program. The test lasted 15 months.
CMS said it costs Medicare more to support care for those with diabetes than those without. In total, CMS estimated that Medicare will spend $42 billion more in 2016 for people with diabetes over age 65 who are non-dual eligible.
The group also said that fewer people with diabetes saves both patients and Medicare money because they use fewer expensive prescription drugs and have fewer hospital visits.
Twitter: @JELagasse