Background
The Medicare program is critical to ensuring that the elderly and others in the United States are able to access necessary health care. Nearly all physicians in the United States participate in the Medicare program, meaning its role as a payer is influential across the entire health care system. In recent years the program has undergone changes with a shift toward the use of value-based payments, the start of the Quality Payment Program, and an increase in testing different practice and payment models through the Centers for Medicare and Medicaid Innovation and other avenues.
ADVOCACY WIN
ACP said that many of the provisions in the proposed 2024 Medicare Physician Fee Schedule will better recognize the value of internal medicine and improve continuity of care. However, ACP is calling for action to prevent scheduled payment cuts.
Where We Stand
The American College of Physicians advocates to ensure that Medicare meets the needs of internal medicine physicians and their patients. We support the goal of aligning physician payments with the efficient delivery of high-quality care to patients. We support improvements that would do away with unnecessary administrative burdens that divert physicians away from patient care. For the transition to value-based payments to work, performance measures used for payment or public accountability must be evidence-based, clinically relevant, and appropriate; and internal medicine physicians must be given ample opportunity to participate in a range of diverse alternative payment models that can accommodate a wide range of specialties, practice sizes, and unique patient populations.
- PolicyPromoting Transparency and Alignment in Medicare Advantage 10/2017
- PolicyReforming Medicare in the Age of Deficit Reduction 4/2012
Latest Advocacy Efforts
- LetterACP Support Letter to Congressional Appropriators for FY2025 Report Language to Help Avoid Unnecessary Medicare Physician Cuts Due to Utilization Overestimates 10/25/2024
- LetterACP Response to RFI on Medicare Administrative Contractor Consolidation and Contract Award Period of Performance 10/4/2024
- TestimonyACP Statement to Ways and Means Health Subcommittee's Hearing "Investing in a Healthier America: Chronic Disease Prevention and Treatment" 9/18/2024
- TestimonyACP Statement to Senate Finance Committee Supporting Benefits in the Inflation Reduction Act to Lower Health Care Costs 9/17/2024
- LetterJoint Letter to Congressional Leaders Regarding Annual Medicare Inflationary Updates 9/10/2024
- LetterACP Comments on 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule 9/6/2024
- SummaryACP Summary of 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule (Member Login Required) 8/20/2024
- LetterACP Response to the RFI for the Pay PCPs Act, S. 4338 7/15/2024
Search the ACP Policy Library
To access everything ACP has said related to Medicare reform issues search all policy statements, copies of testimony, and letters to government and non-government officials.
Medicare and the Quality Payment Program
Additional Advocacy Efforts
- Internal Medicine Physicians Encouraged by Potential for Medicare Fee Schedule to Strengthen Primary Care, Drive Equity and Innovation 7/11/2024
- Value-Based Care Coalition Letter to Congressional Leaders Concerning Policies to Improve Physician Payment 6/27/2024
- ACP Statement to Ways and Means Health Subcommittee's Hearing on Improving Value-Based Care for Patients and Providers 6/26/2024
- ACP Response to Senate Finance Committee White Paper on Bolstering Chronic Care through Physician Payment 6/13/2024
- ACP Statement to the House Energy & Commerce Health Subcommittee on CMMI Hearing 6/13/2024
- ACP Comment Letter to CMS on Proposed Rule Regarding FY 2025 Hospital Inpatient Prospective Payment System and Policy Changes 6/10/2024
- ACP Response to Request for Information on Consolidation in Health Care Markets 6/5/2024
- ACP Letter to the House Energy and Commerce Committee on the Change Healthcare Cyberattack 5/31/2024
- ACP Response to CMS Medicare Advantage Data Request for Information 5/29/2024
- Joint Letter to HHS on Change Healthcare Cyberattack and Reporting Responsibilities 5/20/2024
- ACP Follow-up Letter to HHS on Change Healthcare Cyberattack 5/1/2024
- ACP Letter to National Governors Association on Change Healthcare Cyberattack 5/1/2024
- Joint Letter in Support of Removing Cost-sharing Obligations from the Chronic Care Management Code 4/11/2024
- ACP Statement to the Senate Finance Committee on Bolstering Chronic Care in Medicare 4/11/2024
- ACP Letter to CMS Regarding Accrediting Organizations Proposed Rule 4/11/2024
- ACP Statement for the Record on the House Energy & Commerce Health Subcommittee’s Telehealth Hearing 4/10/2024
- Joint Letter to CMS Regarding Impending Changes to Certified EHR Technology Requirements for ACOs and APMs 4/10/2024
- Internal Medicine Physicians Applaud Final Rule on Short-term Limited Duration Insurance and Other “Junk” Plans 3/28/2024
- Internal Medicine Physicians Encouraged by CMS’ Focus on Primary Care 3/19/2024
- ACP Letter to HHS on Change Healthcare Cyberattack 3/12/2024
- ACP Statement to the Senate Budget Committee Regarding Hearing on Primary Care 3/6/2024
- ACP Letter of Support for the Preserving Seniors’ Access to Physicians Act, H.R.6683 1/2/2024
- ACP Comments on 2024 Physician Fee Schedule and Quality Payment Program Final Rule 12/20/2023
- ACP Letter Expressing Concerns with the Equitable Community Access to Pharmacist Services Act 12/12/2023
- ACP Statement for the Record to the House Energy and Commerce Committee on Markup of Health Care Legislation 12/5/2023
- ACP Letter in Support of Proposed Changes in the Medicare Advantage Rule 12/4/2023
- ACP Letter on the House Energy & Commerce Health Subcommittee’s Hearing on Medicare Proposals 11/20/2023
- ACP Letter on the House Energy & Commerce Health Subcommittee’s 11.15.2023 Markup 11/20/2023
- ACP Letter of Support for the Better Mental Health Care, Lower Drug Costs and Extenders Act 11/16/2023
- Internal Medicine Physicians Say that While Overall 2024 Medicare Payment Cuts are Troubling, the Physician Fee Schedule will Better Value Primary Care 11/3/2023
- Joint Letter to Congress Regarding Budget Neutrality and Physician Payment 10/31/2023
- ACP Statement to the Senate Finance Committee on Medicare Advantage Annual Enrollment: Cracking Down on Deceptive Practices and Improving Senior Experiences 10/18/2023
- ACP Letter of Support for the Improving Seniors’ Timely Access to Care Act 10/18/2023
- ACP Statement in Response to the House Ways and Means Committee's RFI Regarding Improving Access to Health Care in Rural and Underserved Areas 10/5/2023
- ACP Background on Supporting Continuity and Coordination of Care for Patients Through Implementation of Medicare’s Add-on Code G2211 10/3/2023
- ACP Comments on Proposed 2024 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Rule 9/11/2023
- Joint Comment Letter Regarding Transitional Care Management Codes 9/11/2023
- Coalition Letter to Congressional Leaders in Support of Implementing G2211 9/7/2023
- Internal Medicine Physicians Say Medicare Drug Price Negotiation is Important to Lowering Costs 8/29/2023
- ACP Letter to CMS Regarding Episode-Based Payment Model RFI 8/17/2023
- (ACP Members Only) ACP Summary of Proposed 2024 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Rule 8/16/2023
- ACP Letter to CMS on Making Care Primary (MCP) Model 8/10/2023
- Joint Letter to Congressional Leaders Supporting Implementation of G2211 8/1/2023
- Joint Letter in Support of the Value in Health Care Act of 2023 7/27/2023
- Internal Medicine Physicians Supportive of Several Proposals in 2024 Medicare Rules; Call for Additional Provisions 7/14/2023
- ACP Says New Primary Care Model Aligns with Recommendations to CMS 6/9/2023
- ACP Letter of Support for S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act 6/1/2023
- Joint Letter in Support of H.R. 2474, the Strengthening Medicare for Patients and Providers Act 5/3/2023
- ACP Letter of Support for H.R. 2474 the Strengthening Medicare for Patients and Providers Act 4/28/2023
- Coalition Letter Supporting the Chronic Care Management Improvement Act of 2023 4/25/2023
- ACP Comments Regarding HHS' Nursing Home Ownership Disclosure Proposed Rule 4/14/2023
- Internal Medicine Physicians Say Changes to Medicare Advantage Program Will Help Seniors Access Care 4/6/2023
- Internal Medicine Physicians Say Medicare Physician Payment Bill First Step to Correcting Broken System 4/6/2023
- Internal Medicine Physicians Say President's Budget Recognizes Importance of Medicare 3/8/2023
- Internal Medicine Physicians Say Increased Transparency into Nursing Home Ownership is Important Step in Improving Care 2/14/2023
- ACP Comments on CMS’ Proposed Changes to Medicare Advantage and Part D 2/13/2023
- Coalition Letter to Congressional Leaders Regarding Value-Based Care 2/13/2023
- Joint Letter to CMS Regarding Telehealth Flexibilities and Payment 1/26/2023
- Coalition Letter to the 118th Congress Advocating for Medicare Payment Reform 1/23/2023
- ACP Letter to Congressional Leaders Regarding Priorities for the 118th Congress 1/18/2023
- Joint Statement on Health Provisions in Omnibus Legislation 1/11/2023
- Internal Medicine Physicians Say Congress’ Approach to Medicare Payments Falls Short of Protecting Access 12/20/2022
- ACP Letter to the Senate Finance Committee Regarding Behavioral Health Integration Discussion Draft Legislation 12/13/2022
- Physicians and Other Healthcare Clinicians Launch a Week of Action to Prevent Devastating Cuts to Medicare, Harming Patients 12/5/2022
- ACP Comments on 2023 Physician Fee Schedule and Quality Payment Program Final Rule 12/5/2022
- Letter to Congressional Leadership Regarding Medicare Payment Cuts 12/1/2022
- Joint Letter to Congressional Appropriators for Year-End Funding Requests 11/30/2022
- ACP Summary of 2023 Physician Fee Schedule and Quality Payment Program Final Rule (ACP Member Login Required) 11/21/2022
- ACP Response to AHRQ RFI re: Person-Centered Care Planning for Multiple Chronic Conditions 11/15/2022
- ACP Response to RFI re: Promoting Efficiency, Reducing Burden, and Advancing Equity within CMS Programs 11/4/2022
- Internal Medicine Physicians Call on Congress to Prevent Medicare Payment Cuts for Physicians 11/2/2022
- ACP Response to RFI Concerning Policies to Improve Physician Payment and MACRA 10/28/2022
- LetterJoint Letter in Support of Extending Medicare's Advanced Alternative Payment Model Incentive Payments 9/28/2022
- Letter to Congressional Leaders to Prevent Medicare Payment Cuts in 2023 9/23/2022
- Internal Medicine Physicians Say Reducing Administrative Burdens Will Help Patients Get More Timely Access to Care 9/14/2022
- Internal Medicine Physicians Say “Supporting Medicare Providers Act of 2022” Would Maintain Medicare Payment Stability 9/13/2022
- ACP Comments on 2023 Physician Fee Schedule and Quality Payment Program Proposed Rule 9/6/2022
- Joint Letter to CMS Requesting Extension on Medicare Advantage RFI 8/29/2022
- ACP Summary of 2023 Physician Fee Schedule and Quality Payment Program Proposed Rule (ACP member login required) 8/18/2022
- ACP Letter to the Department of Health Services Regarding What the Federal Government Can Do to Strengthen Primary Health Care in the US 8/1/2022
- Coalition Letter to Urge Congressional Leaders to Prevent Cuts in the Medicare Physician Fee Schedule in 2023 7/27/2022
- Internal Medicine Physicians Encouraged by Proposals in 2023 Medicare Rules 7/8/2022
- ACP Comment Letter to the Senate Finance Committee Regarding Tele-Mental Health Draft Legislation 6/16/2022
- Characteristics of a Rational Medicare Payment System 5/26/2022
- Joint Letter to CMS Regarding Behavioral Health 4/19/2022
- ACP Statement to the Senate Finance Committee - Prescription Drug Price Inflation - An Urgent Need to Lower Drug Prices in Medicare 3/16/2022
- Joint Letter to CMS Regarding Medicare Split/Shared Evaluation and Management Visits 3/22/2022
- ACP Response to Proposed Merit-based Incentive Payment System(MIPS) Value Pathways (MVPs) Changes 3/16/2022
- Joint Letter to Congressional Leadership on Extension of Telehealth Flexibilities 3/8/2022
- ACP Comments on CMS’ CY23 Medicare Advantage (Part C) and Medicare Prescription Drug Benefit (Part D) Programs Proposed Rule 3/7/2022
- Joint Letter Urging Transparency and Stability in the Transition to Value-based Care 2/15/2022
- Joint Letter to CMS Urging Extension Draft MIPS Cost Measures Field Testing 2/14/2022
- ACP Letter to Congressional Leaders Sharing Our Priorities for Telehealth in the 117th Congress 2/14/2022
- Extending Telehealth Measures Important Step for Care Delivery Say Internists 2/8/2022
- ACP Statement to the Senate Finance Committee on the Hospital Insurance Trust Fund and the Future of Medicare Financing 2/2/2022
- Internists Say Physician Payments Should Not Be Frozen 1/14/2022
- ACP Comments on CMMI Driving Health System Transformation White Paper 1/12/2022
- ACP Comments on 2022 Final Physician Fee Schedule & Quality Payment Program Rule 12/21/2021
- ACP Summary of 2022 Medicare Physician Fee Schedule (MPFS) & Quality Payment Program (QPP) Final Rule 12/3/2021
- ACP Comments on 2022 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule 12/2/2021
- Joint Letter to Congressional Leadership Urging Immediate Extension of Medicare Budget Neutrality Payment into Calendar Year 2022 12/2/2021
- Joint Letter to Congress Urging Action to Extend MPFS Payment Adjustments Through 2022 11/29/2021
- Joint Letter Requesting the Extension of Technical Support Program for Small Physician Practices Using MVP Initiatives 11/19/2021
- Internists Say 2022 Medicare Fee Schedule Includes Positive Changes for Physicians 11/3/2021
- Internists Say Strategy Outlined for Innovation Office is Promising 10/20/2021
- Joint Letter to CMS Requesting Guidance Regarding Physicians' Right to Receive Basic EFT Payments 10/14/2021
- Joint Letter Urging CMS to Allow ACOs to Use Pre-Pandemic Years for Benchmarks for PY2022 10/14/2021
- ACP Comments on 2022 Physician Fee Schedule & Quality Payment Program Proposed Rule 9/13/2021
- Joint Letter to HHS Urging Advancement of Value-Based Payment as a Health Equity Tool 9/9/2021
- ACP Letter to the Senate Finance Committee with Recommendations for FY2022 Budget Reconciliation 9/1/2021
- ACP Letter to the Ways and Means Committee with Recommendations for FY2022 Budget Reconciliation 9/1/2021
- ACP Comment Letter Regarding the Updating Payment Parameters 2022 Proposed Rule 8/24/2021
- Joint Letter to Congress Urging the Inclusion of the Value in Health Care Act of 2021 in the Reconciliation Bill 8/24/2021
- ACP Summary of 2022 Proposed Physician Fee Schedule & Quality Payment Program 8/23/2021
- Joint Letter in Support of The Value in Health Care Act of 2021 7/20/2021
- Internists Encouraged by a Number of Policies in Proposed Medicare Rules 7/14/2021
- Joint Letter to Senate Finance Committee Requesting Hearings on the Implementation of MACRA 5/26/2021
- Joint Letter to Ways and Means Committee Requesting Hearings on the Implementation of MACRA 5/26/2021
- Joint Letter to Energy and Commerce Committee Requesting Hearings on the Implementation of MACRA 5/26/2021
- Joint Letter to CMMI with Recommendations for Improving APMs 5/25/2021
- Joint Letter to Center for Medicare and Medicaid Innovation Asking for a Transition After the Sunset of CPC+ 5/14/2021
- ACP Letter to Congressional Leadership in Support of Provisions in the Biden's American Families Plan 5/13/2021
- Joint Letter Requesting to Delay Mandatory Reporting CQMs and Implement Changes to the Medicare Shared Savings Program Quality Overhaul 5/4/2021
- Joint Letter with AAFP with Recommendations Regarding the Primary Care First Model 5/3/2021
- Improve Payment Policies to Support Primary and Cognitive Care Handout 4/14/2021
- Joint Letter to CMS With Recommendations for Merit-Based Payment System (MIPS) Value Pathway Implementation 3/5/2021
- ACP Statement for the Record to the House Energy and Commerce Committee on Telehealth During COVID-19 2/2/2021
- ACP Comments on 2021 Final Physician Fee Schedule & Quality Payment Program Rule 2/1/2021
- ACP Comment Letter to CMS on Medicare Part B Most Favored Nation IFR 1/25/2021
- ACP Written Comments for CMS MVP Stakeholder Town Hall 1/14/2021
- ACP Summary of 2021 Final Physician Fee Schedule & Quality Payment Program 12/23/2020
- ACP Says COVID-19 Relief Legislation Advances Essential Policies to Support Patients and Physicians 12/22/2020
- ACP Letter to President-Elect Biden Regarding Policy Recommendations for the New Administration 12/10/2020
- ACP Says 2021 Medicare Physician Fee Schedule and QPP Rule Makes Positive Steps, Improvements Still Needed 12/9/2020
- Joint Statement in Support of Increased Values for E/M Services in final 2021 Medicare Physician Fee Schedule 12/8/2020
- Letter to Secretary Azar in Opposition of the Proposed Rule "Securing Updated and Necessary Statutory Evaluations Timely" 12/4/2020
- Letter to Congress Urging Support to Improve Payment for Evaluation and Management Services in the 2021 Medicare Physician Fee Schedule 12/2/2020
- ACP Says Medicare’s Announced Payment Increases for Office Visits Are Essential to Patient Care 12/2/2020
- Joint Letter to Congressional Leadership in Support for Increased Investment in Primary Care 1/30/2020
- Quotes from Members of Congress Who Support Increased Payments for Evaluation and Management Services in Medicare 11/30/2020
- Joint Coalition Letter to Congress Urging Legislation to Hold Some Codes Harmless from Budget Neutrality For One Year and to Allow E/M increases, GPC1X to Move Forward 11/20/2020
- Coalition Letter on QP Threshold Increases 11/19/2020
- Joint Coalition Statement in Support of Medicare’s Plan to Pay More for Office Visits and Other Essential Services10/21/2020
- Joint Asks to Congress to Stabilize, Strengthen, and Sustain Primary Care During the COVID-19 Pandemic 10/7/2020
- ACP Comments on Proposed 2021 Medicare Physician Fee Schedule (PFS) Rule 10/2/2020
- Coalition Letter on ACO Changes in 2021 Proposed Physician Fee Schedule/Quality Payment Program Proposed Rule 9/23/2020
- ACP Comments to CMS/Acumen on MIPS Cost Measures Under Development 9/17/2020
- Internists Urge Congress to Support Planned Increases in Payments for E/M Services 9/11/2020
- ACP Cover Letter and Document to Members of Congress in Support of the 2021 Medicare Physician Fee Schedule Rule 9/11/2020
- ACP Summary of 2021 Proposed Physician Fee Schedule & Quality Payment Program 9/10/2020
- Internists Provide Recommendations to Improve PTAC Evaluation Process 8/14/2020
- ACP Comments to the PTAC in Response to Request for Public Input 8/13/2020
- Sign-On Letter to the PTAC in Response to Request for Public Input 8/13/2020
- Internists Say Quality Payment Program Needs to Better Accommodate Physicians Dealing with COVID-19 8/7/2020
- Internists Say Medicare’s Changes to Payments for Office Visits Will Help Physicians and Practices 7/24/2020
- Leading Health Groups Praise Introduction of Value in Health Care Act 7/24/2020
- ACP Comments on 2021 Inpatient Prospective Payment System Proposed Rule 7/9/2020
- Joint Letter to Congressional Leaders Supporting E/M Increases in 2021 Medicare Physician Fee Schedule Final Rule 7/6/2020
- Sign-On Letter to CMS Supporting CMS Finalized Documentation Guidelines for 2021 MPFS 6/30/2020
- ACP Urges CMS to Extend Flexibilities in the Quality Payment Program Due to the COVID-19 Crisis 6/12/2020
- ACP Letter to CMS with Recommendations for Long-term Recovery of Quality Payment Program from COVID-19 6/12/2020
- Response to CMS First Interim Final Rule on COVID-19 6/1/2020
- Coalition Letter on Supporting ACOs through COVID-19 Public Health Emergency 5/14/2020
- ACP Letter Requesting Additional Actions from CMS during COVID-19 Pandemic 5/7/2020
- Sign-On Letter in Support of CMS' MIPS Value Pathway to Reduce Burden and Focus Reporting on Patient Outcomes 4/10/2020
- ACP Recommendations to CMS regarding Coverage of and Payment for Telehealth During the 2019 Novel Coronavirus Disease (COVID-19) National Emergency 3/18/2020
- ACP Letter to Secretary Azar Regarding SARS-CoV-2 Virus and COVID-19 Virus 3/4/2020
- ACP's MIPS Value Pathway (MVP) Feedback and Proposal for 2021 Implementation 2/28/2020
- ACP Comments on 2020 Medicare Physician Fee Schedule (MPFS) Final 2/28/2020
- ACP Comment Letter to Representatives Regarding Strengthening Innovation in Medicare and Medicaid Act 2/18/2020
- ACP Subspecialty Sign-on Letter to CMS regarding E/M Codes 2/10/2020
- The "Medical Neighborhood" - Advanced Alternative Payment Model (AAPM) Proposal 1/28/2020
- ACP Letter to CMS Regarding Scope of Practice Requirements 1/17/2020
- ACP Comments on CMS’ Proposed Rule Updating Stark Law to Accommodate Value-Based Payments 12/31/2019
- ACP Comments on HHS OIG’s Proposed Rule Updating Anti-Kickback Statute to Accommodate Value-Based Payments 12/31/2019
- Internal Medicine Sign On Letter to Health Committees for E/M Fee Schedule Final Ruling 11/21/2019
- ACP Encouraged by Future Changes to MIPS, Urge Continued Focus on Burden Reduction in Final QPP Rule 11/7/2019
- Letter to Finance Committee Regarding E/M 2020 Fee Schedule Final Ruling 11/6/2019
- Letter to House Health Committees Regarding E/M 2020 Fee Schedule Final Ruling 11/6/2019
- Internists Applaud CMS for Raising Payments for Office Visits, Reducing Documentation in Final Payment Rule 11/4/2019
- Letter to HHS on Improving Medicare for Seniors 10/29/2019
- Rural ACO Improvement Act Sign-On Letter of Support 10/22/2019
- ACP One Pager Summarizing 2020 Physician Fee Schedule Recommendations 10/15/2019
- ACP One Pagers Summarizing 2020 Quality Payment Program Recommendations 10/15/2019
- Internists Commend CMS for Bolstering Primary Care and Supporting Patients in Proposed Physician Fee Schedule 9/27/2019
- ACP Comments on 2020 Medicare Physician Fee Schedule, Quality Payment Program, and other Medicare Part B Updates Proposed Rule 9/27/2019
- ACP Joins Eight Other Groups in Letter Urging CMS to Pay Out 2017 Advanced APM Bonuses 9/17/2019
- Summary of Physician Fee Schedule & Quality Payment Program Proposed Rule 2020 9/4/2019
- ACP Response to CMS Request for Information on Reducing Administrative Burden 8/12/2019
- Internists Applaud CMS for Putting Patients at the Center, Supporting Primary Care in Proposed Physician Fee Schedule 7/30/2019
- Letter to CMMI on Primary Care First Model 7/10/2019
- ACP Letter to Ways and Means Committee for June 26, 2019 Markup 6/25/2019
- ACP Response to the Ways and Means and Energy and Commerce Committees on Bipartisan Medicare Part D Drug Pricing Legislation 6/6/2019
- Joint Letter to Congress on MACRA Improvement Recommendations 6/3/2019
- ACP Response to CMMI RFI on Direct Contracting Model Geographic Option 5/30/2019
- ACP Letter to CMS on Development of a MIPS Outcome Measure for Hospital Admission Rates for Patients with Multiple Chronic Conditions 5/24/2019
- Statement for the Record: Senate Finance Committee Hearing on Medicare Physician Payment Reform After Two Years - Examining MACRA Implementation and the Road Ahead 5/8/2019
- Joint Letter to CMS on Medicare Appropriate Use Criteria (AUC) Program 4/29/2019
- Internists Encouraged By CMS Announcement of New Payment and Delivery Models to Support Primary Care 4/23/2019