AAFP Statement: 2014 Proposed Medicare Physician Payment Schedule
Positive Steps Overshadowed by Looming Threat of SGR Cuts
FOR IMMEDIATE RELEASE
Tuesday, July 9, 2013
Statement attributable to:
Jeffrey Cain, MD, President, American Academy of Family Physicians
LEAWOOD, Kan. — “If the United States is going to achieve meaningful health system reform, we must have meaningful Medicare physician payment reform. In its proposed 2014 Medicare physician fee schedule, CMS made good steps toward that goal by adjusting misvalued codes and proposing two new codes for complex chronic care management.
“Within the constraints of the dysfunctional sustainable growth rate formula that dictates Medicare physician payment, the proposals are encouraging. But they can go only so far because the pending SGR cuts undermine CMS’ efforts. The ultimate result: a continued threat to Americans’ access to primary medical care.
“Largely as a result of adjustments to misvalued codes, CMS would raise payment for evaluation and management services by 2 to 3 percent. CMS estimates that family physicians would realize a 1 percent overall increase in payment for their medical expertise, but only if Congress averts the pending SGR cuts scheduled to occur on January 1, 2014.
“Such changes demonstrate CMS’ intent to support primary care through policies that promote comprehensive and continuous care. But, in light of the SGR’s mandate that CMS slash Medicare physician payment by 24.4 percent, these incremental increases do nothing to sustain primary medical care, much less build the primary care physician workforce. The SGR-required payment cut shines a bright light on the need for Congress to replace this dysfunctional system.
“If Congress fails to avert this disastrous pay cut before 2014, family physicians once again will be forced to choose between caring for Medicare beneficiaries at a significant financial loss or ending their participation in Medicare. Worse, the impact of a 24.4 percent Medicare cut will snowball as commercial insurers, who often base their payment on the Medicare rate, reduce their reimbursement to physicians as well. An American Academy of Family Physicians analysis of the proposed cut shows the typical family physician would lose a total of $89,763 and a three-physician practice would lose $269,289 in revenue next year. No small business can sustain itself in the face of such drastic revenue reductions.
“The AAFP calls on Congress to repeal the SGR by passing the Medicare Physician Payment Innovation Act (HR 574). The bill repeals the SGR, establishes annual, positive updates on physician payment, provides for a transition to a sustainable payment system and helps better recognize the value of primary medical care.
“Congress has eloquently expressed its concern about the dire shortages of primary care physicians and other professionals. But when it comes to changing policies and making an investment in building the primary care physician workforce, their actions are woefully inadequate.
“It’s time to walk the walk. We again call on Congress to repeal the flawed sustainable growth rate formula that imposes annual threats to elderly and disabled patients’ access to needed care.”
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Founded in 1947, the AAFP represents 110,600 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.
Approximately one in four of all office visits are made to family physicians. That is nearly 214 million office visits each year — nearly 74 million more than the next largest medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.
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