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AHA: Obama Budget Proposes 'Troubling Reductions'

Scott Mace, for HealthLeaders Media, April 11, 2013

"The president's proposals align with many of the principles developed by the AMA and 110 other physician organizations on transitioning Medicare to include an array of accountable payment models," said AMA president Jeremy Lazarus, MD, in a press statement. "It is critical for physicians to have a period of stability and the flexibility to choose options that will help them lower costs and improve the quality of care for their patients."

While eliminating the SGR would be a step forward, the budget takes a step backwards by aiming to achieve more savings through the Medicare Independent Payment Advisory Board (IPAB), which would set another arbitrary spending target and rely solely on payment cuts to reach it, Lazarus says. The AMA strongly supports bipartisan proposals to eliminate this panel, he added.

"We are also concerned with other proposals in the president's budget, including cuts to graduate medical education (GME) programs known as residencies," Lazarus said. "In 2013, 528 U.S. medical school seniors failed to match to a residency program. As the nation deals with a physician shortage, it is important that all medical students can complete their training and care for patients."

Both the AHA and the National Association of Public Hospitals and Health Systems (NAPH) applauded the Administration's willingness to delay cuts to disproportionate share hospital (DSH) payments until 2015, given the uncertain future of Medicaid expansion. "But we're concerned the delay comes at the expense of higher DSH cuts the following two years and a $3.6 billion baseline adjustment in 2023," said Bruce Siegel, MD, MPH, president and CEO of NAPH in prepared remarks.

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