Outlook 2014: Physicians

Physicians hope 2014 is the year Congress finally repeals the hated Medicare sustainable growth-rate payment formula, which has loomed annually as a financial hammer over their heads.

That hope, however, is tempered by fear. Doctors benefited when Congress in December passed a three-month SGR fix, allowing lawmakers a little more time to agree on legislation and funding for repealing the Part B formula. Still, physicians worry that the temporary fix will lead to yet another short-term patch, and then another and another, which has been an annual event in Washington for nearly 11 years.

Another temporary fix “is always a possibility because the can has been kicked down the road every time,” said Dr. Reid Blackwelder, president of the American Academy of Family Physicians. “The encouraging thing about the latest proposal is that it's bipartisan and bicameral.”

See a slideshow of the people to watch in 2014

He said family physicians are looking forward to the prospect that more patients in 2014 will have insurance because of the healthcare reform law, noting that on average family doctors see nine patients a week who do not have a payment source and can't afford to pay out of pocket.

Dr. Peter Angood, CEO of the American College of Physician Executives, predicted that “the benefits of the employed physician model will become increasingly apparent” in 2014. He also hopes Congress repeals the SGR and replaces it with a funding formula that “emphasizes quality, rewards value over volume and creates incentives for physicians to switch to alternative delivery models such as accountable care organizations,” he said.

Dr. Robert Wachter, associate chairman of the department of medicine at the University of California at San Francisco, predicted that accountable care organizations will keep growing in 2014. He said Congress may repeal the SGR but will attach the repeal to legislation “turbocharging” pay for performance. He also sees 2014 as a year of innovation in health information technology. “Many institutions, including mine, will be training people, including clinicians, to get under the hood of IT systems to begin to extract meaningful data.”

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