Are Doctors Better Off Without the SGR?

Elyas Bakhtiari, for HealthLeaders Media , July 23, 2009

But physicians are among those lobbying groups competing for lawmakers' attention. If physician groups hadn't lobbied Congress to block scheduled payment cuts the last few years, physician reimbursement could actually be much lower.

That may no longer be an issue if reimbursement is detached from the SGR formula, but some specialty physician groups are worried about being cut off from the decision-making process. The Alliance of Specialty Medicine has come out against a similar proposal to give MedPAC more authority, arguing that unelected appointees can't be held accountable for their decisions.

The organization claims that their opposition has nothing to do with divisions between specialists and primary care, but that denial may reveal their real concern.

MedPAC has concluded that primary care services are undervalued and some specialist services are overvalued, and by lobbying Congress, specialists have helped defer major readjustments for a while. An independent council may be more inclined to redistribute reimbursement from specialists to primary care than elected representatives.

So the answer to the earlier question, about whether the new method will be better than the SGR, may depend on what type of medicine you practice.

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Elyas Bakhtiari is a freelance editor for HealthLeaders Media.

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