Physicians Ask Congress for SGR Alternatives

John Commins, for HealthLeaders Media , May 30, 2012

Physicians' advocates have asked Congress to scrap Medicare's widely reviled sustainable growth rate (SGR) payment scheme and replace it with flexible payment options that reward quality and efficiency.

The House Ways & Means Committee in April had asked the American Medical Association and the Medical Group Management Association to suggest alternatives to the SGR, which is scheduled for a 30.9% reduction on Jan. 1, 2013.

AMA CEO James L. Madara, MD, in a May 25 letter to the committee said any cost-efficient payment model redesigns should give physicians the resources and flexibility to keep patients healthier, improve care coordination, manage chronic conditions, reduce duplication of services, and prevent avoidable admissions. 

"For Medicare's physician payment system to move in this direction, there needs to be a transition period with opportunities for physicians to move into innovative payment and delivery models in ways that enable them to gain skills and experience in taking accountability for improving care and lowering growth in costs," Madara wrote.

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2 comments on "Physicians Ask Congress for SGR Alternatives"

DonS (6/4/2012 at 4:35 PM)
The SGR must be addressed this year. Beginning in 2013 and for 2014, PPACA mandates that States Medicaid rates for primary care E&M be at least Medicare rates. The States will have trouble putting this in place if the SGR rolls on with Congressional patches and the 'doc-fix' isnt decided on until the last minute - or like in some years, not until after January 1!

Joshua (5/30/2012 at 11:39 AM)
It was great to read your article, and even better to hear both the MGMA and AMA make the case for alternatives rather than simply avoiding the SGR. The government needs to evoke incentives for quality outcomes and the providers (both hospitals and physicians) can aptly bring these quality outcomes when working together. Global payment, ACOs, and results-based payment for treatments have historically been rejected by physician advocates. However, coming to a joint agreement and leaving behind one-size-fits-all will be beneficial to both patients and providers.




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