Bipartisan push to fix doctors’ Medicare payNews added by Benefits Pro on November 1, 2013

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By Dan Berman

The bipartisan leaders of two key congressional committees have endorsed a sweeping change in the way doctors are paid under Medicare.

The chairmen of the House Ways and Means and Senate Finance committees say they support linking the fees paid doctors to the quality of care delivered rather than the current Medicare system, which is based on the volume of care dispensed. With no change, those fees would be cut by about 24 percent on Jan. 1.

The Finance committee chairman, Sen. Max Baucus, D-Mont., and the Ways and Means chairman, Dave Camp, R-Mich., along with next highest ranking members of each panel, Sen. Orrin Hatch, R-Utah, and Rep. Sander Levin, D-Mich., all back the plan, according to Kaiser Health News.

“For years, Medicare payments to doctors have been at risk of getting slashed, limiting seniors' access to high quality care,” Baucus told Kaiser. “Enough with the quick fixes. Our proposal is for a new physician payment system that rewards value over volume.”

According to a draft discussion document, the plan would scrap what’s known as the Sustainable Growth Rate formula, which has been in place since 1997. Under the lawmakers’ plan, payments to doctors would be frozen through 2023. During the next decade, the new system would be phased in as programs to measure the value of services are tested and adopted. By 2017, physicians would be eligible to collect extra fees based on performance and value.

The Congressional Budget Office had recently lowered its estimate of the savings – to $139 billion from $316 billion – that would accrue by keeping the existing formula in place for the next decade. That change, according to the draft discussion, helped spur talks that led to the proposal.

The American Medical Association released a statement praising the idea.

“Congress is demonstrating that they understand that ending the failed SGR this year is fiscally responsible, and that the current Medicare payment system is a barrier to adoption of health care delivery and payment reforms that will improve health care for America’s seniors and rein in overall costs,” AMA President Ardis Hoven said in the statement.

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