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Proposal Creates Pathway to Better Payment Models
May 9, 2012
The American College of Physicians (ACP) today applauded Rep.
Allyson Schwartz (D-Pa.) and Rep. Joe Heck (R-Nev.) for their
bipartisan introduction of H.R. 5707, the Medicare Physician
Payment Innovation Act of 2012 this morning.
The bill is designed to eliminate the flawed Sustainable Growth
Rate (SGR) formula and the turmoil brought by its resulting
scheduled cuts. The SGR cuts threaten to drive physicians out of
the Medicare and TriCare programs, creating severe access problems
for seniors, disabled persons, and military families. (TriCare
updates are set by the Medicare SGR formula, so military families
are at the same risk of losing access to doctors because of the
scheduled cuts as persons enrolled in Medicare.) The legislation
stabilizes payments for six years, provides higher updates for
undervalued primary and coordinated care services, and creates a
pathway to new physician payment models that would better align
payment with value to patients.
"Over the past decade, the repeated threat of cuts to physician
payments resulting from the SGR have brought chaos to the practice
environment," said David L. Bronson, MD, FACP, president of ACP.
"It is difficult for physicians to keep their doors open,
especially for our members in practices that care for underserved
populations, particularly in the nation's low income and rural
communities, with the constant threat of Medicare payments being
cut by a quarter or more."
Every year since 2001, the Sustainable Growth Rate (SGR)
formula, which is used to determine payments for physicians'
services under Medicare, has threatened to impose steep cuts in
Medicare payments for care provided to America's seniors. While
Congress typically acts to avert payment reductions, the average
Medicare payment rate this year is essentially the same as it was
in 2001. By consistently postponing the cuts, Congress has dug a
hole that has grown to hundreds of billions of dollars. Unless
Congress acts to fix this flawed payment formula, doctors will face
a projected cut of nearly 30 percent on January 1, 2013.
"We enthusiastically support this legislation," continued Dr.
Bronson. "It not only addresses the continued threat of the SGR
formula, it also moves Medicare beyond a pure fee-for-service
payment model toward new models that better align payment with
The legislation will:
ACP believes that the bipartisan Medicare Physician Payment
Innovation Act will benefit seniors, disabled persons and military
families," concluded Dr. Bronson. "We strongly urge Congress to
pass the bill before the next scheduled SGR cut on January 1,
The American College of Physicians (www.acponline.org) is the largest medical
specialty organization and the second-largest physician group in
the United States. ACP members include 132,000 internal medicine
physicians (internists), related subspecialists, and medical
students. Internists specialize in the prevention, detection, and
treatment of illness in adults. Follow ACP on Twitter and Facebook.
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