Fighting Over the SGR: The Policy & Practice Podcast

The Medicare Payment Advisory Commission (MedPAC) is recommending that Congress throw out the Sustainable Growth Rate (SGR) formula currently used in setting Medicare physician payments. Under that formula, physicians are due to have their Medicare payments cut by about 30% on Jan. 1. But while doctors are unanimous in their loathing of the SGR, there are differing opinions about how to solve the problems with how Medicare pays physicians.

Courtesy Wikimedia Commons/Psychonaught/Creative Commons License

Check out the Policy & Practice podcast to hear how MedPAC wants to pay for its SGR fix and what objections physician groups are raising about the plan. This week’s podcast also features news on the Institute of Medicine’s recommendations on what should be included in an essential package of health insurance benefits for health plans operating in the state health insurance exchanges in 2014.

Take a listen:

Join us next week as we follow the deliberations of the Joint Select Committee on Deficit Reduction and what it means for Medicare and other health programs.

— Mary Ellen Schneider  (@MaryEllenNY)

President Talks Medicare Cuts: The Policy & Practice Podcast

Courtesy The White House

President Obama released his plan to cut the deficit and Medicare is being asked to help pay the piper. His plan also gives additional power to the unpopular Independent Payment Advisory Board,  an appointed body that will be charged with cutting Medicare spending.

In other Medicare news, the Medicare Payment Advisory Commission gave more details on its plan to replace the Sustainable Growth Rate formula. Radiologists and the American College of Physicians came out against the plan, which freezes payments to primary care for the next decade.

For more on that and details about yet another court hearing on the Affordable Care Act, listen to this week’s Policy & Practice Podcast.

Stay tuned next week for updates on potential Supreme Court action on the health law and more.

—Frances Correa (@FMCReporting on Twitter)

For Doctors, It’s the SGR: The Policy & Practice Podcast

The Super Committee — officially known as the Joint Select Committee on Deficit Reduction — sat down together officially for the first time last week. With their tight deadline and daunting task, some experts are expressing concern that Super Committee efforts will address the Sustainable Growth Rate formula.

In other SGR news, MedPAC commissioners heard one proposal on how to fix the SGR. While the proposal would lop $100 billion off the price tag for a fix, doctors of many stripes were not pleased with how the savings would be accomplished.

Courtesy Flickr/DonkeyHotey/Creative Commons

Also, a new report from the Census Bureau showed that nearly 100 million more  Americans were uninsured in 2010. However, 18- to 24-year-olds gained coverage. Census officials say that could be because of  provisions in the new health law that keep young people insured through age 26.

For more details, listen to this week’s Policy & Practice Podcast.

Stay tuned next week for an update on Super Committee talks and a debate on what constitutes a “grandfathered” health plan.

—Frances Correa (@FMCReporting)

March Madness on Match Day: The Policy & Practice Podcast

Medical school seniors participated in the annual ritual known as Match Day last week.  After gambling on various picks of where they’d like to spend their residencies, students around the country simultaneously find out which school has chosen them.  This year, 11% more U.S. medical school seniors chose residencies in family medicine, and 8% more chose internal medicine.  (See our news coverage here.) This may be an indications that seniors envision a brighter future in those specialties as a result of the emphasis given to primary care in health reform.

Via Flickr Creative Commons user ConvenienceStoreGourmet

But they may still face the same nagging payment issue that their forbearers have: Medicare’s Sustainable Growth Rate formula, which has called for huge cuts in pay, year-in, year-out.  The Medicare Payment Advisory Commission (MedPAC) presented its annual March report to Congress last week.  Testifying before the Ways & Means Health Subcommittee, chairman Glenn Hackbarth warned that Congress was running out of options to fix the SGR.

Finally, over in the Senate, Republicans grilled HHS Secretary Kathleen Sebelius about why the Administration had not responded to various congressional requests for information on the sausage-making process that led to the Affordable Care Act.  The GOP has said it was shut out and now it wants to know what went on behind the alleged closed doors at the White House and HHS.

To hear more about these stories, take a listen to this week’s podcast:

—Alicia Ault (on Twitter @aliciaault)

Bipartisanship? Not so much

From the House Ways & Means Health Subcommittee hearing on the Medicare Payment Advisory Commission March report to Congress, Longworth House Office building.

Medicare Payment Advisory Commission (MedPAC) Commissioner Glenn Hackbarth found himself doing an Irish jig on St. Patrick’s Day Tuesday as he fielded requests, comments, and complaints from Democrats and Republicans on the Health Subcommittee that fell along clearly predictable party lines. 

Courtesy Flickr Creative Commons User Adam Baker

Subcommittee Chairman Pete Stark  (D-Calif.) set the tone by stating that health care reform started with Medicare and that the private sector had done a poor job with the small portion of the program it has been offered (known as Medicare Advantage).  The ranking Republican member, Wally Herger (Calif.) slammed back with allegations that Medicare is woefully inefficient, that it underpays physicians and hospitals, is rife with fraud and abuse, and that it’s the reason why health care costs so much for private citizens.

“I would strongly urge my friends on the other side to consider the evidence we’ll hear today — about the significant problems in the Medicare program — before trying to force 120 million Americans who currently have private helath insurance into another government-run health plan,” said Mr. Herger.

For the most part, committee members — both Democrats and Republicans — did not seem to actually want Mr. Hackbarth’s opinion or input on anything.   But Mr. Hackbarth is no potted plant.  He managed to give thoughtful responses on a variety of issues — from whether the Part D drug benefit has been a success or a failure to the appropriateness of geographically-determined payment adjustments to the necessity of cost-effectiveness research and how it should be used.

At one point, he was chastised for MedPAC’s supposed lack of diversity.  “You got a Texas guy on there?” asked Republican Rep. Sam Johnson.  Mr. Hackbarth responded no, but said there was a representative from the South.

Courtesy Flickr Creative Commons user exfordy

Although Rep. Herger had suggested initially that Committee members should focus on areas of agreement in the hopes that it could “build the goodwill that could lead to a truly bipartisan health reform proposal,” it was clear by the end of the hearing that goodwill seemed to be in fairly short supply.

– Alicia Ault