The House Committee on Energy and Commerce will hear alternatives to the highly contentious Medicare Sustainable Growth Rate (SGR) formula at a Thursday hearing. The hearing follows up on a March 28 letter to 51 medical organizations in which the committee requested feedback on how to remedy the Medicare payment system, which the committee wrote “… is a major threat to the integrity of the [Medicare] program and the ability of America’s seniors to access quality health care.”
In the letter, the committee said it is determined to replace the SGR this year, calling for a system that reduces spending and pays providers fairly and through a value-based system. Under the SGR, Medicare physician payments are scheduled to cut by 29.5% next year; experts estimate it will cost $300 billion to abandon the formula.
Several medical groups responded to the committee’s request, including the American Medical Association (AMA), the American Osteopathic Association (AOA), the American Academy of Family Physicians (AAFP), the American College of Surgeons (ACS), and the American College of Physicians (ACP).
Although the groups’ approaches to an SGR fix vary, their plans share some similarities: a full repeal of the SGR and creation of a new payment model that break away from a “once size fits all” model. They also suggest a 4-5 year transition period in which physicians can participate in the new payment plan on a voluntary basis.
Additionally, they call for a transition to value-based payment systems and increased emphasis on patient-centered medical homes. The ACS, the AAFP, and the ACP all specifically include the need for higher reimbursements for primary care in their plans.
The committee hearing will be held at 10 a.m. on Thursday. Check here to see if it’s being webcast (they often are).
What do you think Congress should include in any plan to replace the SGR? Tell us in the comments section.
—Frances Correa (@FMCReporting on Twitter)