SGR Ripe for Repeal, Where's Congress?
Opelka of the National Quality Forum, told me that a political consensus appears to be emerging for approval of an alternative payment model over a period of years.
"SGR grew up in the volume-based world, and we tied targets for payment to available dollars. Those available dollars were tied to overall utilization of service demand," Opelka told me in an interview after testifying Tuesday.
"As time moved on, the SGR was not an adequate way of addressing the problem, so we're now doing this healthcare transformation, moving us from a volume proposition to value."
"We need targets somehow aligned so we don't have competing economic forces driving the delivery system," Opelka says. "It's still unclear in everyone's mind how do we actually do that."
For now, all eyes are on Washington to see how this will play out for physicians, and the Medicare patients who rely on them.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
- EHR Systems 'Immature, Costly,' AMA Says
- Anthem Blue Cross, 7 CA Health Systems Create New Challenger, Business Model
- Interstate Medical Licensure Effort Advances
- Data Points to Boom in Private HIX
- Better HCAHPS Scores Protect Revenue
- How to Build a Health Plan from Scratch
- Few Winners Among MSSP Participants
- Technology Lights Up Health Innovation Forum
- Insurers see cost hikes in Partners HealthCare (MA) mergers
- Programs focus on high-risk patients to reduce spending