The new figure, however, assumes a 10-year freeze of physician payment rates. If physicians receive an annual 0.5% rate increase, the cost escalates to $136.1 billion. Also, if Congress does not permanently replace or temporarily “patch” the SGR, the CBO said physician Medicare payments would be subject to an SGR-driven 23.7% decrease on Jan. 1.
Baucus and Hatch have said that paying for the SGR repeal will be addressed in separate legislation, but it remains an obstacle to getting it done. The 43,000-member American College of Cardiology has come out in favor of the bipartisan measures before Congress, particularly provisions that promote the use of clinical data registries and the development of quality measures. But the ACC noted that its support could waiver if it disagrees with the method in which the repeal is paid for.
“We caution that our final support rests upon the caveat that paying for this legislation must not cause harm to patients and the physicians who care for them,” Dr. John Harold, ACC president, wrote in a letter to the Senate Finance Committee leaders and their counterparts on the House Ways and Means Committee, Chairman Dave Camp (R-Mich.) and ranking member Rep. Sander Levin (D-Mich.).
The 225,000-member American Medical Association is supporting an alternative House proposal (PDF) that includes three years of 0.5% increases to physician payment rates.
“Importantly, the chairman's mark includes key improvements over an earlier draft proposal, including three years of positive updates to Medicare physician payments,” said Dr. Ardis Dee Hoven, AMA president, in a statement released to the media. “Reliable payment updates are essential to supporting physician practice investments and advancing health system innovation that will improve care for patients.”
In a speech last month at the AMA House of Delegates interim meeting in Washington, Hoven said a proposal to freeze rates that are already 20% below the coast of delivering care “makes you want to throw up your hands and scream.” But she added that a freeze is a better alternative to payment cuts that were also being discussed.
The 45,000-member American Osteopathic Association noted in a news release that it was encouraged by the commitment Congress has shown to solving the SGR problem and urged legislators to continue working toward a system that adequately values physician services and promotes innovative payment models.
The 110,600 member American Academy of Family Physicians called on Congress “to finally strike this payment policy from the books” and acknowledged that this may have to occur through a less-than-optimum legislative vehicle.
“No piece of legislation is perfect, but opportunities such as these are hard to come by,” Dr. Reid Blackwelder, AAFP president, said in a news release. “The Senate Finance and the House Ways and Means committees' proposal takes the important steps of aligning delivery and payment policies.”
The Texas Medical Association, the largest state physician group with 47,000 members, summed up its position with a news release carrying the headline: "SGR repeal bill good, could be better, must pass".
The TMA also teamed up with a coalition of state medical societies from Arizona, California, Florida, Louisiana, New York, North Carolina, Oklahoma and South Carolina to send a letter to Baucus, Camp, Hatch and Levin. The letter supported proposals that called for annual rate updates and payment for chronic-care management, and it also called for putting ICD-10 implementation on hold and retaining a Medicare fee-for-service program.
The 8,000-member American Association of Neurological Surgeons, which also participated in the American College of Surgeons-led coalition, issued a release condemning the idea of a 10-year payment freeze noting that “physicians simply cannot continue to stay in practice under these circumstances.”
The AANS also called for retaining fee for service.
“While we understand that policymakers favor moving to a new value-based purchasing payment system, such an approach will not work for all physicians and patients,” the release stated. “It is essential that a viable fee-for-service option remain in place, which is not achieved with pay freezes and additional cuts under the proposed pay-for-performance scheme.”
Follow Andis Robeznieks on Twitter: @MHARobeznieks
