In 2024, the National Academies of Sciences, Engineering, and Medicine were tasked with convening a committee to examine the current process and data inputs used by the Centers for Medicare and Medicaid Services (CMS) to valuate primary care in the Physician Fee Schedule. Additionally, the committee was tasked with outlining alternative methodologies for data collection and potential sources of input to more accurately capture the time, intensity, and complexity of the work required to deliver high-quality primary care.

The resulting report, Improving Primary Care Valuation Decisions for the Physician Fee Schedule by the Center for Medicare, makes specific recommendations for CMS to address the systemic flaws currently affecting primary care professionals and limiting the potential of high-quality primary care services for all.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON IMPROVING PRIMARY CARE VALUATION DECISIONS FOR THE PHYSCIAN FEE SCHEDULE BY THE CENTER FOR MEDICARE
• Reviewers
• Acronyms and Abbreviations
• Improving Primary Care Valuation Processes to Inform the Physician Fee Schedule
  • CURRENT DATA INPUTS AND PROCESS USED BY THE CENTER FOR MEDICARE TO VALUATE PRIMARY CARE IN THE PHYSICIAN FEE SCHEDULE
  • RECENT PHYSICIAN FEE SCHEDULE CHANGES IN SUPPORT OF PRIMARY CARE
  • NEW CONSIDERATIONS FOR THE VALUATION OF PRIMARY CARE
  • HOW THESE INPUTS COULD TRANSLATE INTO HYBRID PRIMARY CARE PAYMENTS
  • RECOMMENDATIONS
  • CONCLUSIONS
• REFERENCES
• A. Statement of Task
• B. Committee, Fellows, and Staff Biographical Sketches
• C. Public Meeting Agenda

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2025. Improving primary care valuation processes to inform the physician fee schedule. Washington, DC: National Academies Press. https://doi.org/10.17226/29069.

Digital Object Identifier: https://doi.org/10.17226/29069

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242; http://www.nap.edu.

Printed in the United States of America.