Doc groups call for SGR repeal, financial incentives

While the industry waits to see if Congress will postpone the 27.4 percent cut to physician Medicare reimbursement scheduled for Jan. 1, physician groups are throwing their weight behind efforts to repeal and replace the sustainable growth rate (SGR) formula.

For instance, a new plan by Rep. Allyson Schwartz (D-Pa.) seeks to throw out SGR and freeze payment rates at 2011 levels for one year, followed by a five-year transition period to a new payment model, reports MedPage Today.

Then from 2013 to 2016, primary care providers would get a 2.5 percent annual increase while reimbursement for other services would rise 0.5 percent.

Schwartz also calls for the Center for Medicare and Medicaid Innovation to review new payment models, recommendations on which the Centers for Medicare & Medicaid Services would base a "menu" of at least four options by Oct. 1, 2015.

The American Medical Association (AMA) generally supported the plan, especially the idea to financially incentivize doctors who join the new payment systems, as did the American Osteopathic Association, notes MedPage Today. But the AMA objected to penalizing doctors who still participate in fee-for-service.

The American College of Physicians (ACP) praised Schwartz's SGR repeal plan for outlining a schedule to implement new healthcare payment models, the article notes.

The proposal was sent to the bipartisan "supercommittee" for consideration, which failed to come up with a plan to slash $1.2 trillion from the deficit.

Physicians had asked the supercommitee to replace to the "broken Medicare physician payment formula," AMA President Peter Carmel wrote in a Health Affairs blog post last week. The scheduled payment cut comes as Medicare faces a 20 percent gap between payments updates and the rising cost of care, he noted.

For physicians seeking something other than a 27.4% cut, FierceHealthFinance last week presented six alternatives to the SGR formula to consider and analyzed their likelihood of being adopted.

For more information:
- read the MedPage Today article
- check out the Health Affairs blog post

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