House committee asks doctors for ideas on fixing SGR

The House Energy and Commerce Committee is seeking feedback from 51 medical associations on how to fix the Sustainable Growth Rate – the formula used by the Centers for Medicare and Medicaid Services to control Medicare payments to physicians.

A letter from the committee points out that the need to fix the SGR is considerable, since doctors are facing a 29 percent payment reduction in 2012 and costs to abandon the formula are estimated to be as high as  $300 billion.

Congress has passed several temporary fixes since 2002 to delay reductions in physician payment, but such overrides are not sustainable, the letter says. With a lack on consensus on how to fix the Medicare physician payment schedule, the committee is seeking ideas that would translate into legislation.

[See related story: Congress approves temporary pay cut reprieve]

"For too long, Congress has failed to address the outdated physician payment system. Each time Congress delays action, the costs to taxpayers and providers increase," said Committee Chairman Fred Upton (R-Mich.) in a press release. "The committee is committed to working together to implement a permanent, sustainable solution this year that lessens taxpayers' burden and ensures providers have the resources they need to provide quality care to patients."

The House Energy and Commerce Committee plans to hold a hearing on the SGR problem in May and is soliciting "specific ideas and proposals from physician organizations and the provider community on how to reform the physician payment system and move to a system that reduces spending, pays providers fairly and pays for services according to their value to the beneficiary." Ideas will be accepted through the end of April.

"We are pleased that the Energy and Commerce Committee has reached out to a variety of stakeholders, including hospitals, for comments and look forward to working together to find solutions," said Matt Fenwick, a spokesman for the American Hospital Association.

"We know that the physician payment formula is broken and we have long supported a replacement," Fenwick said. "The fix should be done in a manner that does not result in reduced payments to other providers. Lacking a permanent solution, legislation should be enacted to prevent the cuts to physicians scheduled to begin Jan. 1, 2012, with sufficient planning time so as to not impact beneficiary access to care."

"We're pleased that the Energy and Commerce Committee and its Subcommittee on Health has asked physician groups to comment on the SGR Medicare payment issue," Roland Goertz, MD, president of the American Academy of Family Physicians says. "Gathering input from those in the field who actually deal with the process is important. The AAFP will respond and suggest an increased emphasis on primary care payments in an attempt to further the development of the patient centered medical home model of care delivery, a model that has shown in study after study, the ability to decrease health care costs while delivering the highest quality of care to patients."