Assessing the impact of rural provider services mix on the Primary Care Incentive Payment Program

Abstract

Key Findings. (1) Based on analysis of 2009 Medicare claims data, more than 70% of rural primary care physicians (PCP) and non-physician practitioners (NPP) qualify for payments under the Primary Care Incentive Payment Program (PCIP) threshold (i.e., meet the > 60% of allowable Medicare charges). (2) The average incentive payment for qualifying rural PCPs would result in an additional $8,000 in Medicare patient revenue per year. For qualifying NPPs, the result is an additional $3,000 in Medicare patient revenue per year. (3) Only 9% of non-qualifying rural primary care providers were within 10 percentage points of the minimum threshold (60%) of Medicare allowed charges to qualify for PCIP payments.