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The country’s underinvestment in primary care means missed opportunities to catch chronic disease early and help patients change unhealthy habits before those become costly, said the leader of Medicare’s Innovation Center.
“We underinvest in primary care at the current prevailing payment rates,” said Abe Sutton, director of the Center for Medicare and Medicaid Innovation (CMMI).
Sutton pointed to the health care system’s reliance on a fee-for-service model tied to relative value units, or RVUs. The formula determines how much Medicare pays for a service based largely on the time, skill and resources it requires.
Meanwhile, the United States has a smaller supply of general practitioners than other countries in part because of how Medicare prices services, agreed Joe Albanese, director of policy for Medicare. The Centers for Medicare & Medicaid Services (CMS) calculates prices using cost data rather than the value a service delivers to patients, a practice that has “compounding impacts” on the primary care workforce over time, Albanese said.