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May 08, 2013 12:00 AM

Consensus builds for 5-year SGR transition period

Rich Daly
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    Providers are coalescing around a five-year transition period before moving to a new Medicare physician payment system, according to a House Republican involved in developing the replacement.

    Rep. Kevin Brady (R-Texas), chairman of the Ways and Means Health Subcommittee, said the next question in developing a sustainable growth-rate replacement measure that is expected to pass this year is how much time is needed even before that transition period begins.

    “Obviously one of the questions is how far ahead of that do you need to agree on those quality measures so physicians have a chance to plans and prepare and feel comfortable doing it,” he said to reporters. “So we're going to explore that a little further.”

    Brady declined to give a timeframe in which he and his Republican colleagues are expected to introduce their long-awaited SGR replacement measure.

    The question of appropriate transition periods arose repeatedly in a Tuesday hearing by Brady's panel, which featured testimony from provider and insurance representatives.

    Dr. David Hoyt, executive director of the American College of Surgeons, said if such an “accelerated” timeframe is followed, then Congress needs to improve data-crunching abilities available to physicians, as well as beef up incentives.

    Brady said rural physicians may face some of the biggest challenges in moving toward a payment system that is tied to quality reporting, although greater data interconnectivity has lessened that barrier.

    Alternately, Rep. Allyson Schwartz (D-Pa.) said she wanted to get started “right now” on a four- to five-year move toward a new payment system. Schwartz has introduced her own legislation to push Medicare toward new payment models but it's unlikely to advance in the Republican-led chamber.

    Brady said House Republicans crafting the Republican SGR-replacement bill are focused on finding ways to cover the $138 billion, 10-year cost of repealing Medicare's cost-control formula. Even though the Congressional Budget Office-provided estimates dropped in February from its earlier expectation of a $245 billion cost, the challenge of finding a bipartisan way to pay for eliminating still appears the chief hurdle to reforming Medicare physician payments.

    Follow Rich Daly on Twitter: @MHrdaly

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