Reforming Medicare Physician Payment: Fixing SGR While Improving Care

The Medicare Sustainable Growth Rate (SGR) is poised to trigger a 21 percent across-the-board cut to physician payments if Congress does not act by March 30. Each year since 2003, Congress has bypassed the draconian cuts by implementing a short-term “doc fix” legislation; an approach that leads to unpredictability for providers, Congressional inefficiency and missed opportunities for improvements in care delivery. In 2013, a tri-committee bill was developed to permanently fix the SGR, including the adoption of value-based payment models such as bundled payments, medical homes and accountable care models. However, due to the surmounting cost of a permanent solution — over $100 billion — the prospect of a long-term solution is daunting.

On January 28, the Merkin Initiative for Payment Reform and Clinical Leadership hosted an event that convened clinicians, payers and policy experts to discuss feasible strategies for permanently solving the SGR problem. It included remarks from Patrick Conway of the Centers for Medicare and Medicaid Services and Hon. Michael Burgess (R-TX) and Gene Greene (D-TX) from the U.S. House of Representatives.

Download the discussion paper from the event, “Medicare Physician Payment Reform: Securing the Connection Between Value and Payment.”

Download Alice Rivlin’s prepared testimony to the House Energy and Commerce Committee Subcommittee on Health, “A Permanent Solution to the SGR: The Time is Now.”