There's no truth to rumors that, in lieu of replacing the sustainable growth-rate formula used to calculate healthcare provider Medicare payments, Congress is working on a tax break so physicians can deduct the cost of white lab coats and other clinical apparel. According to those rumors, this proposal was cynically called "Clothes, but no SGR."
ACOs and payment woes: The year that was for physicians
OK. That's not true. I just needed to post that pun somewhere other than in e-mails to my co-workers (who, I'm sure, find it hilariously funny). The SGR faded from public discourse for most of 2011 only to resurface in November for another round of Congressional can-kicking and temporary-fix discussions. (By the way, I was compelled to use the standard zeitgeist-measurement of our times, the Google search, and found that a search of "SGR + Congress + kick the can down the road" turned up 8,850 references.)
In other 2011 acronym news, accountable care organizations, or ACOs, continued to garner attention. The year began with anticipation followed by disappointment and then relief as physicians waited to see what the CMS would propose for its Medicare shared-savings ACO model. After the CMS' proposed rule was released in March, it was like air being let out of a balloon. This was particularly true with the American Medical Group Association, which has promoted the concept and whose members—large multispecialty medical groups—are the most likely candidates to create ACOs.
At the AMGA's annual meeting in April, Dr. Robert Nesse, the group's chairman-elect and a member of the Mayo Clinic board of trustees, was asked how close the CMS would come to its goal of getting 150 organizations to sign up as ACOs. Nesse replied 0% to 5% and clarified that "at any given week, there's probably a rate of psychosis of around 5%."
Some relief was felt, however, when the Medical Group Management Association held its annual meeting in October after the final rule came out. The number of quality measures had been reduced to 33 from 65 and all of the hospital-related measures were removed—thus liberating doctors to establish their own ACOs without the need to be linked to a hospital.
Both the AMGA and MGMA, whose member organizations continue to consolidate, saw growth this year despite a shrinking membership pool. The MGMA is 4.6% bigger than it was the year before, rising to 22,500 individual members who lead some 13,700 medical groups in which 280,000 physicians practice. The AMGA started 2011 with 390 groups in which 117,000 physicians practice. This month, it reported that—despite frequent acquisition of member groups by other member groups—it has more than 400 member groups with more than 125,000 doctors.
In 2011, the MGMA leadership changed as Dr. Susan Turney replaced Dr. William Jessee, who served as president and CEO for 12 years. Donald Fisher, the AMGA's president and CEO since October 1980, says he can't retire, because—after the 2008 stock-market collapse—his "401(k) is now a 101(k)."
Follow Andis Robeznieks on Twitter: @MHARobeznieks.
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