The Primary Care Cliff

Just about everyone in Washington knows that the Medicare SGR formula is about to cut payments to physicians by 21% on April 1, unless Congress overrules it. How many know, though, that primary care physicians are also facing a scheduled Medicare cut of 10% on Jan. 1, 2016, unless Congress overrules it, which would be in addition to the SGR cut? Not too many, I suspect.

If Congress allows Medicare primary care payments to be cut on Jan. 1, it would be the second consecutive year when federal payments to primary care physicians -- and only primary care physicians -- would be cut by double-digits. On the first of this year, Medicaid payments to primary care doctors were cut in most states by an average of 40%, because Congress failed to reauthorize a federally-funded program, called the Medicaid Primary Care Pay Parity program that, in 2013 and 2014, raised Medicaid payments for office visits, vaccines, and other primary care services to no less than the applicable Medicare rates.