How Payment Reform Could Enable Primary Care to Respond to COVID-19May 1, 2020
Primary care practices across the country are transforming the way they provide care in response to the COVID-19 pandemic. Practices are devising new protocols to isolate patients with possible COVID-19, navigating shortages of personal protective equipment, providing behavioral health support to patients with emotional distress from social isolation, and managing as much care as possible through telehealth. To better equip practices for such changes, primary care payment reform is needed, both to provide sufficient funds for transformation and to uncouple payment from the delivery of specific services. This brief reviews the pros and cons of different payment models and payment model features for primary care, describes efforts by the Centers for Medicare and Medicaid Services to move away from fee-for-service payments for primary care in demonstration projects, and concludes with a recommendation to universally institute risk-adjusted, prospective per-member-per-month payments for the majority of primary care payments now.