AMA President Optimistic About A Fix For Medicare's Doctor Payment Formula

Debated and despised, the Medicare physician payment formula may finally be on the way out — at least that’s what AMA President Ardis Hoven believes.

Known as the “sustainable growth rate” or SGR, the formula routinely threatens double-digit payment reduction to doctors until Congress steps in at the last minute to stop the cuts. Currently a 25 percent cut looms Jan. 1 unless Congress takes action again.

An admitted optimist, Hoven says she sees plenty of evidence to support her view that Congress is prepared to pass a permanent SGR fix this year. The AMA president points to wide bipartisan support in both chambers. She notes that the House Energy and Commerce Committee passed SGR legislation before the August break — well before the usual end-of-the-year scramble that has been the usual path to a short-term SGR fix. The House Ways and Means and Senate Finance panels are also actively working on a solution. “This is different. This is palpably different,” Hoven says in an interview.

According to the Congressional Budget Office, replacing the SGR would cost about $140 billion, down from earlier estimates as high as $300 billion. But in this era of deficit reduction, it’s unclear where Congress can find that much cash for anything, let alone to pay for the doc fix.

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Source: Kaiser Health News