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Is Medicare Payment Reform Possible?


IP Blog | Dave Melin | February 25, 2014

gavel & stethoscopeEarlier this year ASCO (American Society of Clinical Oncologists) in partnership with COA (Community Oncology Alliance) released a four part physician payment reform proposal.

One of ASCO’s top policy priorities is the repeal of the Sustainable Growth Rate (SGR). The SGR, passed into law in 1997, was designed as a budget cap to control physician spending. “The future of cancer care is bleak if the SGR is not repealed,” said ASCO President Dr. Swain. “Some of our most vulnerable citizens, Medicare beneficiaries who have cancer, need the assurance that they will be able to get the critical care they need.”

Since 2003, Congress has spent almost $150 billion on “quick fixes” to maintain the current SGR and avoid catastrophic cuts that would significantly impact patient care. The current quick fix is scheduled to expire on March 31st. Time is short.

After years of “kicking the can” down the road, Congress seems poised to find a long term solution to the SGR problem. Earlier this month Congress unveiled a bipartisan proposal to repeal and replace the SGR. The SGR Repeal & Medicare Provider Payment Modernization Act (Congressional summary here) would repeal the SGR and move Medicare toward a system based on value. It would also provide needed stability to physicians and patients along with annual updates of 0.5 percent for a period of five years.

The legislation has passed the House Energy & Commerce Committee and Ways & Means Committee along with the Senate Finance Committee. The biggest issue that remains unresolved is how to pay for this proposal.

With all of the uncertainty surrounding Obamacare, it is vital that Congress find a permanent fix to the SGR and provide needed stability to physicians and the patients they serve.

Medicare Payment Reform and the SGR are important issues that directly impact physicians and patients. However, they can also have a significant impact on patients’ ability to access a company’s products.

If you would like to learn more about this SGR proposal or to better understand the impact of the changes to U.S. health care landscape can have on your business, please contact Innovation Partners.


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