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Tuesday Mar 03, 2015

SGR: Time to say goodbye to a familiar foe

In politics, as in many things in business and life, the hardest tasks often are those that come at the end. This is where we find ourselves on a familiar and extremely frustrating issue -- the Medicare sustainable growth rate (SGR).

In less than 30 days, Medicare will implement the largest and most damaging payment cut in its history as a result of the flawed and failed SGR formula -- unless Congress intervenes. Should Congress fail to act and this draconian cut is realized, many of you will face trying questions about your future participation in the Medicare program, and Medicare beneficiaries across the nation could face challenges in securing access to care.

The AAFP is focused on preventing both of these scenarios. In fact, we are committed to ensuring you and your Medicare patients never have to face this dilemma again. Last week the AAFP Board of Directors was in Washington advocating on your behalf. Now, we need your help. We need you to raise your voice and advocate for your patients, yourself and your colleagues. I will tell you how later in this post. For those that can’t wait, please go to Speak Out,  and send a letter to your representative and senator today!

During the 113th Congress, a bipartisan group of representatives and senators introduced the SGR Repeal and Medicare Provider Payment Modernization Act of 2014. This legislation was supported by the AAFP and endorsed by an overwhelming majority of physician and health care organizations. Additionally, it secured the support of the two House committees and one Senate committee with jurisdiction over the Medicare program.

The support for this SGR repeal legislation was bipartisan and solid. Sadly, negotiations on how to finance the legislation prevented its consideration by the full House and Senate, and -- for the 17th time in 12 years -- Congress enacted a safe, comfortable and cowardly short-term patch.

The AAFP continues to strongly support this proposal. On March 2, we wrote to House and Senate leaders urging the immediate enactment of this policy.

There are plenty of provisions in this proposal that will cause some to gnash their teeth, but on the whole, this proposal is a significant step in the right direction and is good for family medicine. The proposal not only repeals the flawed and failed SGR formula, it also puts in place a path for the implementation of new delivery and payment models that transition our health care system from an episodic and volume-driven model to a longitudinal and quality-driven model. Additionally, it provides family physicians practicing in advanced practice models enhanced payments and a simplified administrative burden.

We applaud the work that led to this policy and work that is ongoing to pursue its enactment into law. The 17 short-term fixes Congress has enacted have cost the nation more than $169 billion. We urge Congress to move beyond the short-term, stop-gap measures that have become the accepted course of action on this issue. 

The Medicare program relies on access to a robust primary care physician workforce, yet payment and regulatory policies make it difficult for each of you to provide care to your patients.  Since the establishment of the SGR, physician payments have fallen greater than 20 percent below medical inflation. These stagnant payments have come during the same period that Congress piled more than 20 rules, regulations and new programs on you. Today, each of you are asked to comply with a complex web of regulations that prevent you from focusing on patient care and push you to a level of  frustration that elicits some non-printable comments. 

Family physicians are not only providers of essential health care services; they also are small businesses that create well-paying jobs and contribute to the economic viability of communities small and large. Family physicians are economic engines for your communities. On average, each of you employ five full-time employees and directly produce nearly $1 million in economic activity. Collectively, family physicians nationwide employ more than 350,000 people and generate more than $46 billion in economic activity. It is improbable to believe that any small business can endure a 21 percent reduction in its revenue and an explosion in mandatory compliance to regulations. 

Your frustration with this issue is understandable and I don’t blame you for being annoyed that I am asking you to once again take action in support of repealing the SGR. However, I am asking for you to take action, and I am asking you to channel those 12 years of frustration at your elected officials. I am asking you to SPEAK OUT on behalf of your patients. I am asking you to SPEAK OUT  on behalf of yourself and your practice. I am asking you to SPEAK OUT on behalf of your colleagues. Finally, if it helps, I am asking you to SPEAK OUT simply as a means of venting your frustration. I don’t care which of these factors motivates you to write a letter, but I urge you to do so.

Meaningful Use and PQRS Extensions
On Feb. 25, CMS and the Office of the National Coordinator (ONC) announced an extension in the reporting and attestation periods for eligible professionals participating in the EHR Meaningful Use and PQRS programs. Practices now have until March 20 to complete their attestations and reporting. The AAFP worked closely with CMS and ONC on this extension and is pleased that they made a decision to extend the reporting periods. We were concerned that widespread winter weather events would prohibit many family physicians from meeting the deadlines. 

Posted at 07:00AM Mar 03, 2015 by Shawn Martin

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ABOUT THE AUTHOR



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.