American College of Physicians urges legislators to prevent Medicare payment cuts, repeal SGR

December 18, 2012

The American College of Physicians (ACP) has asked representatives in the U.S. House and Senate to pass legislation that would “create a permanent solution to the endless cycle of Medicare physician payment cuts.”

The American College of Physicians (ACP) has asked representatives in the U.S. House and Senate to pass legislation that would “create a permanent solution to the endless cycle of Medicare physician payment cuts.”

The organization emphasized in a three-page letter to congressional leaders that “there is no plausible route to entitlement reform that does not include full repeal of the Medicare sustainable growth rate (SGR) formula.”

ACP President David L. Bronson, MD, FACP, said in the letter: “Congress has a unique opportunity now, in the context of discussion on the ‘fiscal cliff’ and entitlement reform, to create a clear timetable and policy direction, resulting in permanent SGR repeal no later than next year, accompanied by a transition to value-based payment and delivery system reform. The Medicare SGR formula acts as the greatest single barrier to transition to new approaches to develop new payment and delivery models aligned with value to patients.”

The organization urged Congress to “prevent the nearly 30% cut in Medicare payments to services provided by physicians that will occur after the first of the year-resulting from sequestration and the SGR formula-and create a legislative pathway and timetable for permanent repeal of the SGR and transition to value-based payment and delivery models.”

To permanently replace the SGR, ACP recommends a three-step process:

1. Enact legislation now to stop the scheduled Medicare cut on January 1 that also would provide direction to the Medicare authorizing committees on a policy framework, process, and timetable to report comprehensive legislation to repeal the SGR and transition to value-based payments.

2. In early 2013, authorizing committees would hold hearings, consult with physician membership groups and other stakeholders, and report legislation no later than June 30, 2013, consistent with the policy directions required by step 1 and summarized in more details in the ACP’s letter.

3. By September 30, 2013, Congress would enact comprehensive payment and delivery system reform legislation, based on the bills(s) reported out of the authorizing committees in step 2, to achieve full SGR repeal and establish a framework of positive incentives for physicians to transition to value-based payment models.

Bronson urged Congress to “reach agreement on legislation to prevent the across-the-board sequestration cuts in critically important health programs and, especially, the nearly 30% Medicare payment cut to physicians; establish a pathway and timetable to eliminate the SGR and create positive incentives for physicians to transition to value-based payments; preserve programs to improve Medicaid and Medicare payments for primary care and graduate medical education funding to address the growing shortage of primary care physicians and in many other specialties and to achieve savings in healthcare spending by addressing the real drivers of excess cost.”