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Window to Washington

An inside-the-beltway look at the legislative and regulatory process.
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By Jessica Zigmond and Rich Daly

Don’t bet on a doc-payment formula repeal

By Jessica Zigmond
3:30 pm, May. 4
Tags: Policy

With the Kentucky Derby just a day away, the nation’s physicians might be in a betting mood. But by now, doctors know better than to raise their hopes that the sustainable growth rate formula will be repealed—before the November elections, during the lame-duck session or pretty much at any point during their lifetimes.

Still, they’ll want to take note that Congress will revisit the issue when lawmakers return next week from a weeklong recess. On Thursday, May 10, the Senate Finance Committee will host a roundtable discussion on the SGR that carries a philosophical title: “Medicare Physician Payments: Understanding the Past So We Can Envision the Future.” The panel has lined up some heavy hitters to explore the topic, including two former CMS Administrators: Tom Scully, who now serves as general counsel at Alston & Bird in Washington; and Dr. Mark McClellan, now a senior fellow at the Brookings Institution. Others expected to participate are Gail Wilensky, senior fellow at Project HOPE, and Bruce Vladeck, a senior adviser at Nexera, a New York-based consulting firm.

Meanwhile, Rep. Allyson Schwartz (D-Pa.) is expected to introduce legislation on the SGR “in the coming weeks,” according to her staff communications director. The Pennsylvania Democrat has focused on the issue since the deficit-reduction “supercommittee” hearings last fall and throughout the conference committee discussions on payroll tax legislation—which included a temporary doc fix—this past winter. Her communications director emphasized that Schwartz’s bill is still very much “a work in progress.” (For a summary of the legislation click here.)

Not to be left out, House GOP members recently sent a letter to the physician community that asked a host of questions, including how their organizations think quality, efficiency and patient outcomes should be incorporated in the Medicare physician payment system, and what alternatives to fee-for-service—such as bundled payments or shared savings models—those groups are exploring, as well as the advantages and disadvantages of those initiatives.

So can doctors infer from this upcoming activity that Congress might actually fix Medicare’s flawed physician payment system in 2012?

They’re better off sticking to the ponies.

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