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June 27, 2025 |  By: Mark Richardson & Mike Moen - Public News Service

The current Medicare payment system may benefit from alternative payment models

Medicare provides health care for more than 65 million Americans. A report form the Bipartisan Policy Center concludes the current system for reimbursing primary care physicians requires reform.

(Adobe Stock)

Mark Richardson & Mike Moen - Public News Service

Policy experts said the current Medicare payment system for reimbursing primary care physicians in Kansas and elsewhere is flawed and needs to be revised.

Under the current system, primary care physicians or family doctors are paid based on the number of procedures they perform but not on how well they take care of their patients.

Kendall Strong, senior policy analyst at the nonprofit think tank Bipartisan Policy Center, said their data show Kansas has a high number of rural providers and could benefit from alternative payment models.

"I've seen some data to suggest that the primary care workforce shortage that's impacting the whole nation is particularly acute in Kansas," Strong reported. "Given the value of alternative payment models, it could be really beneficial to clinicians in that state."

Strong pointed out alternative payment models are designed to incentivize high-quality, high-value care by allowing clinicians to focus on specific clinical conditions or populations. She noted the current system undervalues primary care services, leads to inefficiencies and offers fewer incentives for clinicians.

The report issued by the Center found under the current system, excessive reporting requirements and complex quality measures create barriers for smaller and rural practices, leading to clinician burnout. Strong stressed the alternative system is designed to change it.

"Medicare's fee-for-service system rewards providers for the volume of services they provide rather than the value of that care to patients," Strong explained. "Alternative payment models allow providers to be reimbursed for providing a full range of services."

The report also projected a shortage of primary care clinicians could worsen the challenges faced by patients and providers alike. Strong added the Center's report is aimed at getting Congress to change the way primary care physicians are paid under Medicare.