It took 12 years and 17 temporary payment patches at a cost of nearly $170 billion, but Congress finally stepped up to the plate this week by repealing Medicare's long-reviled sustainable growth rate (SGR) formula.
The AAFP and its members had a big role in making that happen.
For years, Academy leaders, staff and individual members worked tirelessly with lawmakers in both chambers of Congress and on both sides of the aisle to secure passage of legislation that would permanently repeal the SGR and begin moving physician payment away from strictly fee-for-service and toward alternative payment models that reward value over volume. Proposals have come and gone during that time; it was only recently that momentum really started to build behind the idea of ending the painful cycle of repeated last-minute congressional interventions to forestall annual SGR-mandated pay cuts.
Congressional support was high last year for the bipartisan SGR Repeal and Medicare Provider Payment Modernization Act(www.govtrack.us), but lawmakers ultimately failed to agree on a plan to pay for the bill. That all changed on April 14, however, when the 114th Congress passed the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act(www.congress.gov).
No easy road, to be sure. Here's just a smattering of AAFP News stories from the past few years showing what it took to reach this goal.
AAFP President Robert Wergin, M.D.; Board Chair Reid Blackwelder, M.D.; and President-elect Wanda Filer, M.D., M.B.A., are shown visiting with Sen. Lamar Alexander, R-Tenn., late last year to push for passage of bipartisan legislation to repeal the fatally flawed sustainable growth rate used to calculate Medicare physician payments. Alexander now chairs the influential Senate Committee on Health, Education, Labor and Pensions.
In February 2014, the Academy reached out to members, urging them to appeal to their legislators to end the frustrating cycle of temporary patches Congress historically has passed at the last minute to avoid devastating physician pay cuts and instead permanently repeal the sustainable growth rate formula used to set payment rates. Members came through in a big way; 663 individuals sent 2,070 letters to legislators.
AAFP officers and staff tallied up more than a dozen visits with key members of Congress, their staff and others in just two days of visits in November 2013. The No. 1 topic: Medicare physician payment reform. Here, (then) AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., left, meets with Rep. Phil Roe, M.D., R-Tenn., to discuss a bipartisan proposal from the Senate Finance and House Ways and Means committees that would repeal the sustainable growth rate formula and replace it with a payment model more focused on quality.
In February 2013, the AAFP threw its support behind the Medicare Physician Payment Innovation Act introduced the previous year by Reps. Allyson Schwartz, D-Pa., and Joseph Heck, D.O., R-Nev. The bill promised to immediately eliminate the sustainable growth rate formula, thus blocking a steep reduction in the Medicare payment rate scheduled to take effect on Jan. 1, 2014. Here, Heck, left, listens as (then) AAFP President Jeff Cain, M.D., makes a point about the legislation's provisions.
In a strong show of unity, the AAFP and other major physician organizations met with House and Senate leaders in December 2012 in a final push to avert a deep reduction in the Medicare physician payment rate set to take effect on Jan. 1, 2013. (Then) AAFP Board Chair Glen Stream, M.D., M.B.I., left, and Charles Cutler, M.D., chair-elect of the American College of Physicians Board of Regents, talk strategy before those meetings.
AAFP leaders kept up the pressure on Congress and the Obama administration for a repeal of the sustainable growth rate (SGR) in two days of meetings in February 2012. Clockwise from left, (then) AAFP Board Chair Roland Goertz, M.D., M.B.A., of Waco, Texas, and President Glen Stream, M.D., M.B.I., meet with Rep. Michael Burgess, R-Texas. Burgess, now a member of the House Energy and Commerce Committee's Subcommittee on Health, has been a long-time proponent of SGR repeal.