Reforming the primary care physician payment system: eliminating E & M codes and creating the financial incentives for an "advanced medical home"

J Ambul Care Manage. 2008 Jan-Mar;31(1):24-31. doi: 10.1097/01.JAC.0000304093.05840.e2.


The problem faced by primary care physicians is that they can only maintain or increase their (inflation adjusted) incomes by increasing the volume of visits and associated services. The fundamental flaw in a fee-for-service system is that only paying for individual services creates incentives for more services. This article offers a very different approach to paying primary care physicians that will result in both significantly higher incomes for these underpaid professionals together with incentives for creating a medical home.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Current Procedural Terminology
  • Fee-for-Service Plans
  • Forms and Records Control*
  • Health Care Reform / economics*
  • Insurance, Health, Reimbursement
  • Medicare / economics
  • Physicians, Family / economics*
  • Reimbursement Mechanisms / organization & administration*
  • Reimbursement, Incentive*
  • Risk Sharing, Financial
  • United States