Under the deal, physicians who embrace alternative pay models would receive higher compensation when the new Medicare payment system is fully implemented. "In 2024 and subsequent years, professionals participating in [alternative payment models] that meet certain criteria would receive annual updates of one percent, while all other professionals would receive annual updates of 0.5 percent."
Alex Hunter, managing director of Chicago-based Navigant Consulting's healthcare practice, said the SGR repeal deal could be a long-term solution to the doc fix dilemma. "This will avert what was viewed by physician organizations as a 'fiscal cliff' for professional reimbursement—given that prior to the repeal of SGR, physicians were facing a possible reduction by 28 percent. Also, the proposed deal will provide a more certain financial environment in which physicians can function and plan for the future," Hunter said.
He said the new Medicare payment system could serve as an engine of change and serve the interests of patients.
"The legislation is viewed by Congress as transitional in nature, with the end game being to develop an approach that integrates value-based programs into the Medicare physician payment system," Hunter said. "During this transition period, physicians will likely continue to seek increased collaboration and coordination among themselves and local health systems. For Medicare patients, this is also good news, as physicians will likely continue to provide access to care without concern for whether their physician can afford to provide services to them."