At a House subcommittee meeting today, medical societies weighed in on how to fix the much-maligned Medicare physician payment formula. The current formula, which absolutely no one thinks can continue in its present form, is (ironically) called the Sustainable Growth Rate, or SGR. It pegs the growth of Medicare reimbursement to the GDP — problematic, since GDP growth has famously been outpaced by the increase in health-care spending for years. Automatic, across-the-board reimbursement cuts kick in if spending reaches a certain level. But it’s so expensive to fix this problem — $298 billion just to wipe out accumulated debt — that nothing permanent has been done. Instead, we’ve seen a Chinese water torture of last-minute, short-term fixes . Scheduled to appear today to suggest their own solutions were representatives of the American Medical Association, American College of Surgeons and American Academy of Family Physicians, among others. Here’s what they offered up, according to their prepared testimony: American Medical Association : Repeal the SGR, then “implement a five-year period of stable Medicare physician payments that keep pace with the growth in medical practice costs.” During that

period, pilot “a new generation of payment models” ( medical homes , for example), then transition to those that improve quality, care coordination and costs. The AMA also wants Medicare to permit balance billing — physicians charging Medicare beneficiaries for an amount above and beyond what the government program covers. American Academy of Family Physicians: After SGR repeal, there would be a five-year transition to the patient-centered medical home . Primary-care physicians would receive a higher reimbursement rate than other specialties, and primary-care incentives included in the health-care overhaul law would be increased and extended. American College of Surgeons: After SGR repeal, set a “realistic budget baseline” for future payment increases, ” which should “fairly reflect the costs of providing quality health care and are sufficient to preserve the patient-physician relationship and ensure patients have continued access to the physician of their choice.” During a five-year transition to different payment models,  reimbursement growth would vary by service. No word on how much any of these suggestions would cost. Image: iStockphoto

Originally posted here:
Medical Societies Weigh in on Permanent Fix to Medicare Reimbursement