In response to the Society of General Internal Medicine's (SGIM) request, the AAN recently submitted recommendations to the National Commission on Physician Payment Reform on how the payment system could be reformed to better reflect the current healthcare environment while reducing costs and increasing quality.
The AAN comments that fragmentation in the current healthcare delivery system impacts the ability of neurologists to provide the highest quality, safest, and most effective care and as such the AAN supports a complete revision of the Medicare fee schedule.
The letter cites research from an AAN–funded University of Cincinnati study that found that the overall work intensity of several specialists was fairly equal and that currently accepted assumptions of differing work intensity among medical specialists may be flawed.
The AAN recommends that the payment system should also be reformed to recognize the importance of cognitive care services by shifting away from a procedure–centered reimbursement model to a patient–centered system by changing the misaligned financial incentives (e.g. primary care incentive bonus) and closing the income gap for primary care and cognitive specialties vs. procedural specialties.
Finally, the Academy suggests that new care coordination models should give incentives not only to primary care physicians, but neurologists and other cognitive specialists who provide the majority of E/M services to participate in a medical neighborhood for patients with complex chronic conditions.
The AAN will continue to monitor this important topic and remains committed to protecting the interests of neurologists in healthcare reform.