Congress currently is looking at legislation that would end the frustrating cycle of temporary fixes to the Medicare sustainable growth rate (SGR) formula for physician payment and allow physicians to take a major step toward improving the quality of patient care. In response, the AAFP is reaching out to members to ask them to urge Congress to act before the latest patch to the SGR expires on March 31.
The proposed law, the SGR Repeal and Medicare Provider Payment Modernization Act(www.govtrack.us), would address the problem by modernizing the Medicare physician payment system while also permitting physicians the flexibility to remain in a value-based, fee-for-service payment system.
The AAFP has crafted a message(cqrcengage.com) members can send to their legislators outlining their support for the legislation and asking those legislators to take action. "For far too long, Congress has put off dealing with the issue of repealing Medicare's flawed SGR formula by temporarily applying patch after patch to prevent triggering drastic cuts to physician reimbursements," says the message from the Academy. "In all, Congress has spent more than $150 billion (during) the past 12 years kicking the can down the road while trying to muster the political will to enact a permanent fix for our nation's seniors and the doctors who treat them."
If Congress doesn't act before March 31, the SGR would require that Medicare payments to physicians be slashed by 24 percent.
The AAFP has urged Congress to repeal the SGR formula for more than a decade to prevent ever-increasing cuts to physician payments. During the past 12 years, Congress has had to enact 16 patches to the SGR, which cost $154 billion. These so-called doc fixes failed to stabilize the Medicare payment process and continue to harm the long-term health prospects of elderly and disabled Americans, the AAFP has said.
The bipartisan legislation introduced Feb. 6 in the House and Senate would permanently repeal the flawed SGR formula and enact reforms that will support improvements in health care delivery, including the patient-centered medical home. "The proposal includes policies that will enable individual family physicians and primary care physician groups to move away from the current system toward more patient-centered, comprehensive reforms that promise greater efficiency, more care coordination, and less duplication and fragmentation," said AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., in a statement from the AAFP.
The habit of passing quick fixes for the SGR has a high cost for the nation as a whole and, specifically, for family physicians and their patients, said Blackwelder. Many family physicians with small practices are unable to make long-term plans or expand their operations because the Medicare payment process has been unpredictable for more than a decade.
"By encouraging physicians to build on the patient-centered medical home and exploring alternative payment models, the proposal shifts focus away from delivery and payment models that foster episodic care based on volume. Instead, it moves toward those that facilitate ongoing comprehensive care that reduces intensive medical and inpatient services and focuses on rewarding value," Blackwelder said.
"We urge Congress to seize the opportunity before them to create a new and more stable health care infrastructure for the American people," he added.
Related AAFP News Coverage
Three-Month Payment Patch Should Give Congress Time to Repeal SGR