Healthcare Reform: Report on Impact of PPACA on Rural Health

The Robert Wood Johnson has recently released a report on the impact the new health care reform will have on rural medicine.  The report states that the Patient Protection and Affordable Care Act (ACA) will change Medicare payments for almost every type of health care provider.

For primary care physician, one new aspect of this is a bonus to providers in a primarily non-procedural practice:

Primary care physicians will receive a 10% bonus for ACA-defined "primary care services," but only if those "primary care services" represent at least 60% of the practice. The requirement that at least 60% of a practice’s furnished services must be particular "primary care services" to receive the ACA primary care bonus may preclude eligibility for those rural primary care practices that tend to offer more procedures (thus proportionally fewer primary care services) than urban/suburban practices.  Also, the ACA-defined primary care services currently do not include preventive health services.

AAFP news expands the available information on the primary care bonus:

Section 5501 (a) of the Patient Protection and Affordable Care Act creates an incentive payment program for primary care providers that calls for incentive payments equal to 10 percent of a "primary care practitioner's" allowed charges under Medicare Part B for primary care services provided on or after Jan. 1, 2011, and before Jan. 1, 2016.

For rural physician with a practice consisting of less than 40% procedural services, this will be an additional bonus on top of the HPSA bonus or any other federal bonus programs.