Medicare payment patch: AAFP rallies for longer-term solution

While the recently passed legislation that creates a 1-year extension of current Medicare physician payment rates is a step up from the series of shorter-term patches seen during 2010, it is “only 1 step toward a permanent solution to the flawed sustainable growth rate formula that threatens deep Medicare payment cuts and the financial viability of primary care physician practices,” says Roland Goertz, MD, president, American Academy of Family Physicians (AAFP).

The Medicare and Medicaid Extenders Act of 2010, approved by Congress on December 9, halts a 25% cut to Medicare physician payments under the Sustainable Growth Rate (SGR) formula that would otherwise would have gone into effect on January 1, 2011.

AAFP advocates legislation that would include an SGR patch for 3 to 5 years that will include a differential payment for primary care physicians as well as the study of new payment models.

The proposal also includes extensions of other expiring healthcare provisions, including protections for rural hospitals and doctors, Transitional Medical Assistance, and the Special Diabetes Program.

“Many physicians made clear that this year’s roller coaster ride, caused by 5 delays of this year’s cut, forced them to make difficult practice changes like limiting the number of Medicare patients they could treat,” says Cecil B. Wilson, MD, president of the American Medical Association. “This 1-year delay comes right as the oldest baby boomers reach age 65, adding urgency to the need for a long-term solution before this demographic tsunami swamps the Medicare program.”

To access a PDF of the newly passed legislation, go to: http://finance.senate.gov/legislation/download/?id=e5aff08b-3628-49c3-887c-aa14fd48d20d

A summary is available at: http://finance.senate.gov/legislation/download/?id=9829ab3d-85d4-4715-8891-3ab149b5a87a