We are approaching the end of the year, a time for college football bowls and New Year’s Eve celebrations. Amid the frivolity of these popular winter events, Congress will postpone adjustments to the flawed Medicare sustainable grow rate (SGR) formula until the end of the year.
Without appropriate congressional action, Medicare payments to physicians and other health professionals will decline by a mandated 24.4 percent on Jan. 1, 2014. An identical scenario happened last year and the “eleventh hour” fix was funded primarily by takeaways from hospitals.
The House Ways and Means Committee and Senate Finance committees released a draft proposing a new formula using value-based payments beginning in 2017. The committees’ newly-sprung draft does not identify funding for the proposed physician payment changes. We applaud Congress for seeking a permanent Medicare physician-payment formula, but clearly the funding must be front and center.
The 2013 approach of taking from one hospital to fund other providers is counter-productive to coordinated care and reimbursement. Physicians should receive fair and equitable Medicare reimbursement utilizing a formula that creates value for all stakeholders. We need to determine the best method for funding rather than piecemeal temporary fixes before every New Year. It is unfair to physicians participating in the Medicare program.