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Tuesday Apr 14, 2015

Take a Bow, Physicians -- You Defeated the SGR

No more patches.

No more payment cuts looming on our calendars.

We did it!

When the U.S. Senate passed the bipartisan Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act, or MACRA, tonight, more than a decade of frustration with and instability in the Medicare program ended. The legislation contains many provisions that have long been supported by AAFP members, most notably repeal of the Medicare sustainable growth rate (SGR).

In recent weeks alone, AAFP members weighed in with about 5,000 letters or phone calls to legislators, urging them to support this important legislation.   

Thank you for making your voices heard. The long-awaited action by Congress retroactively negates a 21 percent cut in Medicare payments that took place when the most recent patch expired March 31.

How did we get to this point? Congress created the SGR formula as part of the Balanced Budget Act of 1997 as a way to determine annual updates to the Medicare physician fee schedule. By 2002, the SGR was mandating reductions in physician payments, and we began a nearly annual dance of threatened pay cuts and congressional patches.

In all, Congress used 17 temporary patches to avoid payment cuts at a total cost of nearly $170 billion. The longstanding uncertainty regarding Medicare payments has had adverse effects on the long-term health of our practices, as well as on patients' access to care. In a 2013 survey of Academy members, 9 percent of respondents said they had stopped taking new Medicare patients in the past year, and 10 percent said they had stopped taking new Medicare patients more than a year earlier.

Still, nearly 80 percent of AAFP members continue to take new Medicare patients despite years of uncertainty, and the Senate's vote on MACRA is a victory for us and our patients. In addition to repealing the SGR, the legislation will establish an alternative set of annual payment updates.  The legislation also extends funding for critical programs that affect primary care:

MACRA also addresses another key issue that affects our practices and the health of our patients. The legislation makes interoperability of certified electronic health records a national objective. HHS will be required to establish interoperability metrics next year to measure progress toward achieving that goal by the end of 2018.

The passage of this bill illustrates the value of primary care and the strength of our voice. Thank you for standing with family medicine.

Robert Wergin, M.D., is president of the AAFP.

Posted at 09:56PM Apr 14, 2015 by Robert Wergin, M.D.

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