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Proposal Creates Pathway to Better Payment Models
February 6, 2013
Washington-The American College of Physicians (ACP) today
applauded Rep. Allyson Schwartz (D-Pa.) and Rep. Joe Heck (R-Nev.)
for their bipartisan introduction of The Medicare Physician Payment
Innovation Act of 2013 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 Charles Cutler, MD, FACP, chair-elect of the ACP
board of regents. "It is difficult for physicians to keep their
doors open, especially for our members in small or solo practices,
with the constant threat of Medicare payments being cut by 25
percent 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, 2014.
"We enthusiastically support this legislation," continued Dr.
Cutler. "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 ensures patient access to physicians while
promoting efficiency, quality and value in health care delivery
"ACP believes that the bipartisan Medicare Physician Payment
Innovation Act of 2013 will benefit seniors, disabled persons and
military families," concluded Dr. Cutler. "We strongly urge
Congress to pass the bill before the next scheduled SGR cut on
January 1, 2014."
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 133,000 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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