SGR Ripe for Repeal, Where's Congress?

Joe Cantlupe, for HealthLeaders Media , May 9, 2013

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.
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2 comments on "SGR Ripe for Repeal, Where's Congress?"

michael samms (5/10/2013 at 10:13 AM)
We need a system to address artificial demand creation. Programs addressing quality are always appropriate, but take a long time to widely implement. In the meantime, we need an immediate and effective reimbursement process that will eliminate up to $100 Billion in excess diagnostic services annually. A reimbursement program to slow cost increases will go a long way toward addressing needed reforms and will have an immediate payback. We need Wal-Mart style supply/demand economics which will alleviate the cost concern. Where is Wal-Mart or an organization that will step up?

msamms (5/9/2013 at 5:20 PM)
Artificial demand creation rules current healthcare economics. We could save $100 Billion annually with a proper structure. We need Wal-Mart style supply/demand economics. Begs the question, where is Wal-Mart on healthcare? Perhaps a different question: Who resides outside the current healthcare box and can save the U.S. healthcare system?




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