Hello partners,

Families USA invites you to join us in signing on in support of our response to the Pay Primary Care Providers (PCP) Act Request for Information (RFI).

To read our response, click here, and to sign on please complete this form by 12pm ET on Monday, July 15.

The Pay PCPs Act, introduced in May 2024 by U.S. Senators Sheldon Whitehouse (D-RI) and Bill Cassidy, M.D. (R-LA), takes a critical step in shifting our health care system away from the inefficiencies and perverse incentives of fee-for-service economics by directing CMS to establish a hybrid payment, consisting of both a prospective capitated payment and fee-for-service payment, under the physician fee schedule. The bill would also create a technical advisory committee to inform fee schedule rates.

The RFI attached to the Pay PCPs Act asks critical questions about how hybrid payments for primary care, and the creation of the technical advisory committee should be designed to establish a sustainable reimbursement structure for primary care.

Within our answers, Families USA recommends the Pay PCPs Act:

• The Pay PCPs Act give the Secretary of Health and Human Services authority to make changes and updates to the design of the hybrid primary care payments to strengthen the model and adapt design features based on the model's performance, including the ability to make changes to patient attribution methods, and payment methodology.

• The Pay PCPs Act, work towards incorporating robust social needs and social services data into health care data systems and workflows in order to allow additional measures of health-related social needs to be included in risk adjustment methods to more accurately account for expected health care costs among socially vulnerable and marginalized populations and drive towards equity and improved protections against adverse selection.

• The Pay PCPs Act develop a technical advisory committee that includes a variety of health care payment experts, including non-partisan health care economists, non-physician clinicians, consumer representatives, and physicians across medical specialties.




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