AAFP Joins With Others in Push for Medicare Payment Reform, SGR Repeal

May 03, 2013 04:25 pm News Staff

The AAFP continues to press Congress for repeal of the sustainable growth rate (SGR) formula and enactment of measures to transition Medicare from a volume-based to a value-based system.

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As part of its ongoing effort to repeal and replace the SGR, the AAFP has joined with other members of the broad-based National Coalition on Health Care in sending a letter(nchc.org) to congressional leaders that calls for "bipartisan action this year to permanently repeal the SGR and transition Medicare reimbursement toward a value-based system."

"Since the SGR's enactment, its ill-conceived approach to containing physician costs has repeatedly threatened to disrupt access to care," says the coalition's letter. "Today, there is a growing consensus that the seniors and disabled Americans who depend on Medicare should not have to face this threat again."

The letter comes only a few months after the Congressional Budget Office (CBO) said the cost of repealing the SGR now stands at $138 billion, a decrease of $107 billion from the previous CBO score. The revised CBO estimate has raised renewed hopes that Congress will repeal the SGR this year.

At the same time, the coalition, which represents physicians, other health care providers, consumers, businesses, workers, vulnerable populations and health plans, also is asking Congress to address underlying problems in the health care system. "Whether in Medicare or in the private market, health care costs continue to rise amidst serious and persistent problems in health care quality and access," says the coalition. "To meet these challenges, we must strengthen our capacity to improve health care even as we spend our health care dollars more wisely."

Both the public and private sectors have developed health care models that achieve the simultaneous goals of better care and lower costs, thereby providing a better way forward, says the coalition.

"When patients get the right care at the right time, when care is well-coordinated, and when physicians and other providers have the time to educate and engage their patients, we know that the best of American medicine actually becomes affordable," says the letter. But this type of progress will remain the exception and not the rule "as long as today's volume-based reimbursement remains dominant."

"Because of its unique role as the largest payer for health care, Medicare has a special responsibility to lead the transition to delivery and payment approaches focused on value, including but not limited to value- and quality-based payment, patient-centered medical homes and accountable care."