Don't Count on SGR Reform This Year

Joe Cantlupe, for HealthLeaders Media , May 31, 2012

Physicians' groups offer payment models
Both the AMA and the Medical Group Management Association Medical Group Management Association  have offered the House Ways and Means Committee similar payment models to consider that would advance payment reform.

In her letter, MGMA President/CEO Susan Turney, MD, said she supported "looking at various payment reform models, and the MGMA supports the testing of new models that promote integrated care delivery and encourage cost-effective medical treatment" Options for evaluation include bundled payments, partial capitation, accountable care organizations, medical homes and "other hybrid approaches that couple fee for service payments with a risk based bonus opportunity," she adds.

But "first and foremost," Turney wrote, Congress must act to permanently "repeal the flawed SGR formula used to annually update Medicare physician payment rates."  In the process, Congress should test other payment and delivery models, she added. "Physicians should have the flexibility to adopt different approaches based on their composition, capabilities and community needs."

That all sounds fine. Whether the House Ways and Means Committee does anything remains to be seen.

A year ago last May, the House Energy and Commerce Committee's subcommittee on health conducted a hearing, "The Need to Move Beyond the SGR."

"The committee sent a similar letter last spring (to that of the House Ways and Means Committee, soliciting physician input)" says a healthcare organization official. "And nothing happened."

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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1 comments on "Don't Count on SGR Reform This Year"

DonS (5/31/2012 at 2:50 PM)
Another consideration for SGR repeal or at least bringing in stability to the Medicare PFS for 2013 and 2014 is the Medicaid parity component mandated under PPACA. And that, of course, is assuming the PPACA is still there come January 2013. But if state's Medicaid programs must pay Medicare rates to primary care on E&M codes in January 2013, Congress can't be diddling around with SGR cuts, patches, fixes, or other nonsense into 2013 like they did in 2010.




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