AAFP Launches Grass-Roots Outreach to Urge Repeal of Medicare’s Flawed Payment Formula

LEAWOOD, Kan. — The American Academy of Family Physicians has launched a national grass-roots campaign urging the Joint Select Committee on Deficit Reduction to repeal the sustainable growth rate formula that determines Medicare physician payment.

The campaign is part of the AAFP’s effort to ensure that patients have access to the care they need by stabilizing the Medicare system, according to Glen Stream, MD, president of the AAFP.

“We need to make sure our patients can get the right care from the right health care professional at the right time,” said Stream. “The SGR threatens the financial viability of the physician practices most needed by patients. For seven years, physicians have coped with annual, semi-annual — sometimes monthly — threats of serious cuts in payment for service, and that has blocked them from long-term planning that is necessary to transform to patient-centered medical homes. If we want a high quality, efficient health care system, we must resolve the SGR issue.”

The AAFP’s campaign asks family physicians to tell their U.S. representatives to sign a “Dear Colleague” letter being circulated by U.S. Rep. Allyson Schwartz, D-Pa. The letter urges the Joint Select Committee on Deficit Reduction, known as the supercommittee, to take up the SGR issue.

Established by the Budget Control Act of 2011, the supercommittee is charged with recommending cuts of $1.5 trillion in reductions in the deficit over 10 years from the federal budget by Nov. 23. Failure to pass the plan and garner a presidential signature will mandate that $1.2 trillion in across-the-board cuts be withheld from all federal spending with the exception of Medicaid, Social Security and Medicare benefits. However, the AAFP has warned that preserving benefits fails to protect patient access if physician payment cuts force doctors to close their doors.

“Rep. Schwartz’s ‘Dear Colleague’ letter is important in helping ensure that patients can see their doctors,” said Stream. “We appreciate her leadership on this issue.”

Earlier this year, the AAFP called on the supercommittee to resolve the SGR issue. In an Aug. 10 letter to supercommittee members, the AAFP called for repeal of the SGR, a specified payment update for the next three to five years to allow time for demonstration programs to identify the most effective payment models, and at least a 3 percent higher rate for primary care physicians delivering primary care services. This approach, according to the AAFP policy, will stabilize Medicare and build the primary care physician workforce to meet patients’ needs.

Each year, Congress has overridden the SGR-mandated cuts. However, if implemented, those cuts would force physicians to choose between closing their practices and restricting the number of elderly and disabled patients they can accept. On Jan. 1, 2012, the formula will dictate that Medicare slash physician payment by 30 percent — an amount, according to an AAFP survey, that would force 73 percent of family physicians to limit the number of Medicare appointments they could accept, 62 percent to stop accepting new Medicare patients, and 13 percent to stop providing patient care altogether.