AAFP Joins AMA, Other Groups in Calling on Deficit-reduction Committee to Repeal SGR

The AAFP has signed on to an AMA-drafted letter (4-page PDF; About PDFs) that calls on Congress' Joint Select Committee on Deficit Reduction -- known as the "supercommittee" -- to include a full repeal of the sustainable growth rate, or SGR, formula used in calculating Medicare physician payment as part of its final legislation.

Congress created the bipartisan supercommittee to develop a plan to achieve federal budget cuts and possible revenue increases totaling $1.5 trillion during the next 10 years. If the government fails to enact the committee's recommendations by Dec. 23, across-the-board cuts totaling $1.2 trillion will be triggered automatically.

Meanwhile, physicians face a nearly 30 percent reduction in the Medicare physician payment rate based on the SGR on Jan. 1 unless Congress acts to block the cut. If the cut goes into effect, access to care for the nation's senior and disabled citizens would be threatened, according to the letter.

"The fiscally responsible course is clear," says the letter. "This is the time to repeal the SGR so that new payment models can be adopted that promote high-quality, cost-effective care."

During the past decade, Congress has acted 12 times to block Medicare pay cuts previously called for by the SGR. Yet, as the supercommittee begins its deliberations, the current baseline assumes that "massive physician payment cuts will be implemented," the letter says.

"This SGR deficit is being kept 'off the books,' which is inconsistent with accurate budget practices," says the letter. "In fact, members of Congress from both sides of the aisle have stated that the current law baseline does not reflect the policies that Congress has operated by in recent years. Any effort to stabilize our nation's finances must be based on a true assessment of future expenditures."

The letter also notes that "continued delay in replacing the SGR has escalated the cost of permanent payment reform from $48 billion in 2005 to nearly $300 billion today."

"We estimate additional short-term interventions will double the cost to approximately $600 billion by 2016," the letter adds.

"Other groups that have examined and proposed solutions to the nation's budget crisis -- including the Simpson-Bowles Commission, the Senate Gang of Six, American Enterprise Institute, Heritage Foundation and the Center for American Progress -- all acknowledged that the nation cannot continue to ignore the SGR deficit.

"These proposals called for permanent reform of the Medicare physician payment system while at the same time significantly reducing the federal budget deficit," the letter says.

The AAFP, meanwhile, is supporting a Web-based advocacy campaign dubbed EveryPatientCounts.org that allows physicians, patients, health care administrators and concerned citizens to sign an online petition calling on Congress to repeal the SGR. The petition describes the SGR as "an anchor on the Medicare program," saying it prohibits innovation, contributes to access issues for millions of seniors and serves as a disincentive to physician participation in the Medicare program.

Finding a solution to the SGR problem will not be easy, the petition acknowledges.

"But we believe there are appropriate options that promote quality and preserve access to care for current and future generations of beneficiaries," the petition says. "We urge you to seize this opportunity."