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Strengthening Primary Care Through a Hybrid Payment Model and Fee Schedule Reform

Grant Details

Grantee Organization
Urban Institute

Principal Investigator
Adele Shartzer, Ph.D., M.P.H.

Term
11/1/21 - 6/30/22

Award Amount
$161,655

Approval Year

Related Program
Health Care Delivery System Reform

Topics
Delivery System Reform

Grant Details

Grantee Organization
Urban Institute

Principal Investigator
Adele Shartzer, Ph.D., M.P.H.

Term
11/1/21 - 6/30/22

Award Amount
$161,655

Approval Year

Related Program
Health Care Delivery System Reform

Topics
Delivery System Reform

The project would build on recommendations by the National Academies of Sciences, Engineering, and Medicine, developing actionable federal policy options in two areas: 1) designing a hybrid payment model for primary care, considering issues such as the mix of fee schedule versus population-based payment, performance accountability metrics, and risk adjustment; and 2) improving the Medicare Physician Fee Schedule (MPFS) by developing a process for setting and revaluing misvalued codes that would potentially decrease payments for overpriced services to support redistribution to primary care activities. Each area would be informed by comprehensive literature reviews of approaches tested to date, conversations with issue experts, and an advisory group with deep expertise on MPFS. Policy options will be summarized and shared directly with the primary care community through blog posts and reports.

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