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Lawmakers Want to Reward Medicare Docs for Quality

Legislation takes aim at SGR (February 7)

After negotiating for months over how to overhaul Medicare’s troubled payment system for physicians, the bipartisan leadership of three Senate and House committees has reached a deal on the policy. Their next task is to find a way to finance repeal of the sustainable growth rate (SGR) — the 1997 formula used to set physician payments.

Under the legislation announced February 6, doctors would receive a 0.5% increase for each of the next 5 years as Medicare transitions to a payment system designed to reward physicians based on the quality of care provided, rather than on the quantity, as the SGR does.

However, if lawmakers can’t agree on how to pay for the measure, a permanent fix might have to wait another year.

The new legislation does not include money for a package of Medicare policies — known as “extenders” — that fund therapy services, ambulance services, and rural hospitals, as well as a program that allows low-income people to keep their Medicaid coverage as they transition into employment.

American Medical Association President Ardis Dee Hoven, MD, urged lawmakers to take action before the current SGR patch expires April 1. “Congress has been debating the shortcoming of the SGR policy for more than decade,” she said. “Continuing the cycle of short-term patches by merely addressing the 2014 cut that is imminent on April 1 without solving the underlying problem would be fiscally irresponsible and further undermine the Medicare program.”

Doctors face a 24% reduction in their Medicare reimbursements if Congress doesn’t change current policy.

Source: Kaiser Health News; February 7, 2014.

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