There are only two ways to generate offsets—increase revenue or reduce government spending—and these days in Washington it seems impossible to develop a consensus around either one. Without a consensus "you aren't going to be able to enact a long-term SGR fix" says Condeluci even though everyone seems to agree that a long-term fix is preferred to the annual band-aid fixes.
Williams expects any congressional action to go down to the wire on Dec. 31, as it did last year. That could mean that physicians are in for another rocky ride this fall.
The SGR formula was put in place as part of the Balanced Budget Act of 1997 to help control Medicare spending. It soon became apparent that significant cuts in physician reimbursements would be required to help reduce spending. Since 2003 Congress has routinely declined to make those cuts.
For their part, physicians are losing patience with the process. "All of us can look at this and say we've been here before. It's almost getting to the point of ridiculous. How much more can we talk? How much more new information do we need?" states Brad Flansbaum, DO, a hospitalist at Lenox Hill Hospital in New York City, and a former board member for the Society of Hospital Medicine. Congress knows that the "longer [it] waits, the more it's going to cost. I just don't know how much longer [physicians] can face the patch. We've seen it all before. We know what needs to be done."