Bipartisan Plan Would Shift
Medicare’s Doctor Payment System To Reward Quality
Long battle over how Medicare
compensates physicians takes a new turn; AMA offers support
Mary Agnes Carey, KHN Staff Writer
Sen. Max Baucus, Rep. Fred Upton and Rep. Dave Camp are chairmen
of the committees that wrote the proposal to replace the
Medicare payment formula (Photos via Win McNamee/Getty Images,
House GOP via Flickr, Brendan Smialowski/Getty Images).
Feb. 6, 2014 - The bipartisan
leadership of three Senate and House committees introduced legislation
Thursday to overhaul the way Medicare pays physicians.
The package, which does not specify how it would be paid for, would
repeal the current system, which sets Medicare physician payment rates
through a 1997 formula based on economic growth and known as the "sustainable
growth rate" (SGR). Physicians would receive a 0.5 percent increase
for each of the next five years as Medicare transitions to an
alternative payment model designed toreward physicians based on
the quality of care provided, rather than the quantity, as the current
payment formula does.
"This legislation today provides
stability for physicians so they will no longer face the uncertainty of
massive cuts, but also begins the process of improving how we pay for
medical care to focus on positive results for seniors," Ways and Means
Committee Chairman Dave Camp, R-Mich., said in a statement.
The bipartisan leadership of the
Senate Finance and House Ways and Means and House Energy and Commerce
panels announced the deal -- as the Senate was expected Thursday to
confirm Finance Chairman Max Baucus, D-Mont., to become the next U.S.
Ambassador to China. Baucus had made the SGR fix a top policy priority
and had hoped to wrap up a deal before his departure.
"Congress has spent a decade
lurching from one 'doc fix' to the next, creating a new, unnecessary
threat to seniors’ care each time. Enough is enough," Baucus said in a
statement. "This proposal would bring that cycle to an end and fix the
The American Medical Association
immediately welcomed the compromise. AMA President Ardis Dee Hoven said
in a statement, "Congress has been debating the shortcoming of the SGR
policy for more than decade. … It is time for action to repeal the SGR
and establish a transition to a new more stable Medicare physician
payment policy to better serve America’s senior citizens."
The legislation does not include
funding for a package of Medicare policies – known as extenders -- that
include items such as additional funding for therapy services, ambulance
services and rural hospitals and a program that allows low-income people
to keep their Medicaid coverage as they transition into employment and
earn more money. The extenders were part of the package Senate Finance
approved in December.
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