Whereas, The Phase I Hsiaso/Harvard survey found nursing facility visits to be the most undervalued physician services under Medicare; and
Whereas, A new set of codes and descriptors was created to encompass the new physician work in nursing facility visits required by OBRA ’87 Federal regulations; and
Whereas, Analysis by the Physician Payment Review Commission shows that the relative values for nursing facility visits are less than for comparable office and hospital visits; and
Whereas, Nursing facility visits (both comprehensive assessments and subsequent care) are among the lowest-paid visits; and
Whereas, There is no sound basis for assuming that the work and intensity involved in evaluating and managing nursing home patients should be any less than evaluating and managing patients in the hospital or in the office; therefore be it
RESOLVED, That the American Medical Association supports the findings of the Physician Payment Review Commission that:
Revision is required in the relative values assigned for work in nursing facility visits, and the practice expense component of the relative value scale should be based on estimates of resources rather than on historical charges.
AND BE IT FURTHER RESOLVED, that the American Medical Association should advise HCFA to collect direct cost data required to develop this approach, including data on the direct costs of complying with specific regulatory requirements, such as reporting and record-keeping, which a peculiar to physician practice in the nursing facility site of service.
Note: Effective August 13, 2024, AMDA - The Society for Post-Acute and Long-Term Care Medicine is now Post-Acute and Long-Term Care Medical Association (PALTmed).