(Editor's note: The Senate will take up the House-approved SGR repeal bill after senators return from spring recess on April 13. AAFP President Robert Wergin, M.D., issued a statement encouraging a quick vote: "The House has provided an overwhelming bipartisan vote of approval. The Senate should do no less and should do so as quickly as possible. Americans have already waited 12 years for this vote.")
Family physicians who have long sought an end to Medicare payment uncertainty have reason for optimism following a vote today in the House of Representatives.
For the first time in 12 years, true Medicare reform is feasible under the House legislation, which includes full repeal of the Medicare sustainable growth rate (SGR) formula. Lawmakers passed the bipartisan Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act, or MACRA, by a 392-37 vote. It now moves to the Senate. The AAFP has already sent a letter to Senate leaders(1 page PDF) urging them to pass the legislation.
The AAFP welcomed the House's action to eliminate the SGR and move toward meaningful physician payment reform.
"The AAFP applauds the House for its action and calls on the Senate to pass MACRA as soon as possible," said AAFP President Robert Wergin, M.D., of Milford, Neb.
If enacted, the measure will push Medicare away from paying for the volume of services performed in favor of paying for the value of the health care provided. The bill calls for a payment increase of at least 0.5 percent annually for five years to stabilize the system while physicians transform their practices into new models such as the patient-centered medical home.
"While not a perfect solution to health care delivery reform, MACRA resolves some of our health care system's most pressing issues," Wergin said. "It reinforces reliable access to better, more efficient care for elderly and disabled patients, and it preserves health coverage for our most vulnerable children."
Beyond adoption of meaningful payment reform, the legislation provides financial support for care delivery and education that are crucial for primary care. Also included in the bill are an extension of CHIP, continued funding for community health centers, funding for the National Health Service Corps and an extension of the Teaching Health Center Graduate Medical Education program.
If enacted, the Congressional Budget Office estimates the legislation will cost $140 billion. In the past 12 years, lawmakers have adopted 17 temporary patches to avoid payment cuts called for by the SGR formula, known as "doc fixes," that have cost a total of $169.5 billion. The current patch, passed in 2014, expires on March 31. Without action by lawmakers, physicians face a potential 21 percent cut in Medicare payments.
"The SGR has plagued Medicare patients for far too long," Wergin said. "It's destabilized their access to care and threatened the financial viability of their physicians' practices for more than a decade."
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