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Senators Want Provider Feedback on Medicare Payments

Margaret Dick Tocknell, for HealthLeaders Media, May 14, 2013

Stakeholders have until May 31 to provide responses. What happens after that is anyone's guess. No timetable for future action has been released.

Although there is widespread agreement that the SGR is flawed and needs to be replaced, In a longstanding delay tactic,  Congress has long opted to intervene on an annual basis to prevent physician payment cuts rather than develop a permanent solution. A bipartisan-sponsored  repeal bill introduced in February has the support of  the AMA and the American Academy of Family Physicians among other key physicians groups.


See Also: SGR Ripe for Repeal, Where's Congress?


A Congressional Budget Office analysis released in February 2013 slashed $107 billion from the cost of eliminating the SGR and is credited with resuscitating efforts to repeal the unpopular formula. Whether the seemingly significant financial incentive is enough to overturn the SGR remains to be seen.

Last week the House Ways and Means subcommittee on Health spent several hours exchanging ideas about reforming the SGR with a group of influential healthcare stakeholders. At this point it's difficult to imagine what new information remains to be discovered.

The House Ways and Means Committee sent a similar letter in April 2012 to the American Medical Association and the Medical Group Management Association. In their responses, the AMA and MGMA identified possible alternative payment models, including performance-based and bundled payments.

Baucus and Hatch hosted a number of roundtables about Medicare payments in 2012 that featured physicians, former administrators of the Centers for Medicare & Medicaid Services, and private payers. While those meetings covered a wide range of topics, including models of care, specialty reimbursements, and quality and efficiency, no magic bullets were identified.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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