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Lawmakers Mull SGR Options

Margaret Dick Tocknell, for HealthLeaders Media, May 8, 2013

Bipartisan consensus for repeal of Medicare's sustainable growth rate appears solid, but there is no clear way forward. The latest meeting between lawmakers and stakeholders gives voice to the wide-ranging concerns of physicians.

The House Ways and Means subcommittee on Health spent two hours Tuesday exchanging ideas about reforming Medicare's sustainable growth rate with a group of influential healthcare stakeholders.

That the SGR needs the boot was a foregone conclusion among both the assembled panelists and the House members. In his opening comments, Rep. Kevin Brady (R-TX), committee chair, noted that participants in two previous SGR hearings held recently supported the repeal of SGR. "I couldn't agree more," he said. "The SGR is the major contributor to an unhealthy system and it needs to change this year."

While there was general agreement that a value-based system is preferable to the current volume-based system of physician reimbursement, the wide-ranging discussion among the committee members and the panelists, who included physicians as well as a health plan medical director and a representative of the National Quality Forum (NQF), demonstrated that the devil is indeed in the details.

The discussion was framed around two proposals: HR 574 (Medicare Physician Payment Innovation Act of 2013), a bipartisan effort from Rep. Allyson Schwartz (D-PA) and Rep. Joe Heck (R-NV), and a draft proposal from House Ways and Means chair, Rep. Dave Camp (R-MI) and Fred Upton (R-MI), chair of the House Energy and Commerce Committee.

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