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Medicare Primary Care Bonus Payment Program

Bonus Payment Program Overview

How many general internists will qualify for the bonus payments? Will the 60 percent select primary care services revenue threshold preclude some general internists who provide primary care from receiving the bonus?

During health reform deliberations, ACP advocated that Congress establish a bonus qualification threshold that was more inclusive than what was ultimately included in the ACA. That said, ACP believes that the CMS implementation signifies a reasonable application of ACA provision. The College especially commends CMS for its responsiveness to recommendations made by ACP and others. CMS states that approximately 60 percent of general internists will receive the bonus in 2011 under its final rules. As the 60 percent figure is based on the total number of physicians with a general internist Medicare designation, which includes hospitalists and some other general internists who do not provide office-based primary care, the percentage of ambulatory-based general internists who qualify will be higher than 60 percent. The structure of the primary care bonus program as defined in the Affordable Care Act essential prohibits hospitalists from qualifying to receive the bonus payments.

While CMS did not estimate the number of general internists who would have qualified under its original proposed implementation plan, the College believes it would have been less than 40 percent.

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