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AMA Ads Push for SGR Elimination

John Commins, for HealthLeaders Media, October 13, 2011

The American Medical Association has launched a national media campaign urging the public and physicians to tell Congress to repeal the sustainable growth rate Medicare payment formula before 30% cuts go into effect on Jan. 1.

"We believe Congress needs to come forward with honest accounting at this point and really clear the books on the SGR," AMA Chairman Robert M. Wah, MD, told HealthLeaders Media. "This has been with us for a decade and the problem is that the cost of what they have done so far has just gotten bigger.

Five years ago this problem could have been solved at a cost of about $48 billion. Now to fix it they say it will cost $300 billion. But if they don't deal with it and it goes another five years, the costs will go up to $600 billion."

AMA also rejected a nonbinding recommendation to Congress this month from the Medicare Payment Advisory Commission to kill the SGR and replace it with an equally contentious plan that would include reimbursement cuts to specialists and pay freezes for primary care physicians.

If no action is taken on the SGR and other budget deficit issues by Jan. 1, automatic 30% Medicare reimbursement cuts to physicians are supposed to be implemented, but it's not clear if Congress will allow that to happen.

Instead of cuts or freezes, AMA wants the 12-member budget deficit reduction "super committee" in Congress to provide physicians with a five-year "stability period" on Medicare reimbursements that would include modest inflation adjustments.

"That is what we seek to do with our three-prong plan, which is to repeal the SGR, get five years of stable Medicare payments with inflationary updates, and during those five years work on delivery system improvement and reform that delivers cost effective care for patients in a more coordinated fashion," Wah says. "Then we can fashion a payment system that would facilitate that new deliver system."

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