Medicare should pay more for primary care and less for procedures and specialty care, a Medicare advisory board said at a meeting this week.
Health care winds up costing more when there’s lots of specialty care, but outcomes aren’t necessarily better. Having more primary-care docs, on the other hand, does tend to improve outcomes, a briefing document prepared for the meeting pointed out. Yet the payment system in this country tends to favor specialists, which is part of the reason fewer young docs are going into primary care.
“Accordingly,” the document dryly noted, “primary care services are at risk for being underprovided to the Medicare population.”
So Congress should bump up what Medicare pays for primary care, the commission said. And lawmakers should do it in a “budget-neutral” way, which means paying less for other kinds of care.
This sounds simple enough: If something is important for patients’ health, and it’s being undervalued, we should pay more for it. But in health care, where reimbursement has long been based on the resources required to provide a medical service, it represents a pretty big shift in how to approach health-care costs.
Health Blog Question of the Day: Should Medicare cut reimbursement for specialty care in order to pay more for primary care?