Complexity, Intensity of Primary Medical Care Should Be Valued, Researchers Say

FOR IMMEDIATE RELEASE: Monday, December 1, 2014

Leslie Champlin
Senior Public Relations Strategist
(800) 274-2237, Ext. 5224 

WASHINGTON—Primary care physicians grapple with 23 diagnostic codes in caring for their patients, while subspecialists such as cardiologists use a median of six codes and psychiatrists use three. The comparison, according to a Robert Graham Center study, demonstrates the complexity and intensity of primary medical care. 

That complexity and intensity should be compensated in physician payment, according to the researchers. Their data and conclusions appear in a one-pager titled “Accounting for Complexity: Aligning Current Payment Models with the Breadth of Care by Different Specialties,” published in the December 2014 issue of the journal American Family Physician.

Robert Graham Center researcher Joshua Freeman, MD, and his colleagues calculated the complexity of medical care by reviewing data from the 2011 National Ambulatory Medical Care Survey. 

“These findings are consistent with a recent study that calculated the complexity of family physician visits to be 1.3 times that of cardiologists and five times that of psychiatrists,” Freeman and his coauthors write. “It has been suggested that the difficulty of professional work may be more associated with how many different tasks are being managed and how they interact with each other (the complexity of the work) than how difficult any single task is to complete.”
The authors conclude that the Centers for Medicare and Medicaid Services should account for the complexity of the care offered by primary care physicians and the time required to provide that care by making adjustments to the fee schedule used to pay physicians.


About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.