More than 110 physician specialty and state medical society organizations this week renewed what has become an annual plea for Congress to repeal the sustainable growth rate formula.
If implemented according to schedule, the SGR will cut doctors' Medicare pay 27%, leaving doctors with only 73 cents of every dollar the program pays them today starting on Jan. 1.
The cost of repealing the SGR to restore those payments would be $245 billion over the next 10 years, according to August projections from the Congressional Budget Office.
The physician groups made their plea in a letter this week to Senate Finance Committee members Sen. Orrin Hatch, (R-UT) and Sen. Max Baucus, (D-MT), calling the SGR "an enormous impediment to successful healthcare delivery and payment reforms that can improve the quality of patient care while lowering growth in costs."
In July, Baucus, who is chair of the Senate Finance Committee, hosted five physician group representatives in a roundtable discussion. He noted then that "physicians seem caught in "stove pipes of care. How do we get rid of some of these pipes?"
The physician groups argue that practicing doctors don't have time to "re-design" their practices to adapt to new models of care delivery because of the "constant specter of severe cuts under the SGR."
The doctors also want Congress to embrace a set of core principles they think should be the foundation for a productive transition from the SGR payment system "to a higher performing Medicare program."
The groups are urging Congress to act on these points:
- Reform of the care delivery system is necessary to transition to "a high performing Medicare program that provides patient choice and meets the healthcare needs of a diverse patient population."
- The Centers for Medicare & Medicaid Services "must invest and support physician infrastructure that provides the platform for delivery and payment reform."
- Payment "should reflect costs of providing services as well as efforts and progress on quality improvement and managing costs."
- Transition should reflect diversity of physician practices and provide opportunity for physicians to choose payment models that work for their patients practice, specialty and region.
- Payment should include "incentives and rewards during a defined timetable, instead of using penalties to order abrupt changes in care delivery.
- Payment should include a way to measure progress and show policymakers that physicians are taking accountability for quality and costs.
The physicians groups say the plan structure should:
- Reward physicians for savings
- Enhance prospects for new models
- Tie incentives to a physician's own actions rather than the actions of others or factors beyond their influence
- Harmonize measures and alter incentives in current law
- Encourage collaborative efforts with primary and specialists while preserving patient choice
- Allow specialty and state society initiatives to receive deeming authority
- Recognize the central role of the profession in determining and measuring quality
- Provide exemptions and alternative pathways for physicians in practice situations where recovering investments to achieve reform in care delivery would constitute a hardship.