2016-01-12 14:26:16 UTC

Cognitive Care Specialties Form New Coalition to Save Cognitive Care

AGA joins alliance to support proper reimbursement for specialty care.

Contact: Aimee Frank
301-941-2620
media@gastro.org

Washington, DC (Jan. 13, 2016) — As the Centers for Medicare and Medicaid Services (CMS) is poised to transition physician payment from a system that pays by volume to one that pays for value, they continue to ignore the flawed building blocks of physician reimbursement. All new payment models must properly value cognitive services. These are performed by the physicians who are the skilled in the thinking art of medicine, as opposed to those physicians who are skilling in specific procedures.  

A new Cognitive Care Alliance has been created by specialty societies who treat patients many with multiple, concurrent, complex acute and chronic conditions that require complicated diagnostic strategies and non-procedural treatments, such as chemotherapy and lifelong medications. 

The Alliance has united physicians who practice primary care, rheumatology, gastroenterology, neurology and endocrinology. They are all concerned that the relative pricing for the complex and ongoing purely cognitive services they provide do not accurately capture the intensity of the work and the value provided to the health care system.

“It is essential that the physician workforce represents the thinking as well as the doing traditions of medicine. We have lost an alarming number of those physicians able to deal with the cognitive complexities of modern medical practice due to relative underpayment. We can no longer afford to be complacent and have joined together to become a united voice advocating for a national, independent survey of physician cognitive work and the creation of a revised payment structure that ensures a robust and balanced physician workforce in the future,” Dr. John Goodson, Chair of the Cognitive Care Alliance.

The Alliance was formed to ensure that patients have access to the cognitive services needed to remain healthy and to ensure that all acute and chronic conditions are thoughtfully and effectively managed. Its members believe that CMS must ensure that cognitive services are properly defined and appropriately valued with respect to surgical procedures and other interventions.  

The Resource Based Relative Value Scale (RBRVS) used by Medicare and all other insurance payers to value physician services in relation to one another must be revised to reflect the intensity of current cognitive care. The Alliance believes this must be done based on the collection of data by a nationally representative survey that is funded from existing federal resources. With this knowledge, the RBRVS can be modified to reflect the complexities of purely cognitive services.

For more information or to talk with Dr. Goodson directly, please contact Erika Miller, Executive Director, Cognitive Care Alliance, at 202-484-1100 or emiller@dc-crd.com

A list of the Alliance’s members is below.

American Academy of Neurology
American College of Rheumatology
American Gastroenterological Association
Coalition of State Rheumatology Organizations
The Endocrine Society
Society of General Internal Medicine

More on Medicare incentive/penalty programs

Tips to Avoid a 2019 Payment Penalty

Oct. 19, 2017

Report on one measure for one patient for the 2017 Quality Payment Program Performance Year.

Colonoscopy Cost Measure to be Tested for MIPS

Oct. 4, 2017

Prepare now to share your thoughts on the value of the measure with CMS.

Meet Your 2017 MIPS Reporting Requirements

Sept. 13, 2017

Use AGA Quality Measures and improvement activities and register by Oct. 2 to avoid a payment penalty in 2019.