Senators Seeking Ideas

Senate Finance Committee Chair Max Baucus (D-MT) and Ranking Member Orrin Hatch (R-Utah) are calling for healthcare physicians and other providers from across the country to bring ideas to the table on how to improve Medicare’s physician payment system. According to Senator Baucus speaking at the Senate Finance Committee hearing held May 14th on how to improve the Medicare Physician Payment System said, “The SGR should not simply be repealed. The underlying fee-for-service system that Medicare uses to pay physicians needs to be changed.”

He recounted the actions undertaken by the Senate in recent years. Last year, the Senate Finance Committee held three roundtable sessions on improving the system to reward physicians for providing high-quality high value care. The Committee heard from former CMS Administrators, private plans, and physician groups.

The Committee heard from the CMS Innovation Center and their new ideas for payment systems that include establishing accountable care organizations, payment bundles, and medical homes. Unfortunately, right now the new models that the Innovation Center is developing are not yet ready to replace the fee-for-service system.

The senators have called the current Medicare payment system broken, and said it was time to repeal the flawed formula and end the annual “doc fix” ritual. Since 2003, Congress has made 15 short-term fixes to the Sustainable Growth Rate (SGR) at a cost of nearly $150 billion. In 2010 alone six short-term fixes were passed.

In a May 10th a letter was issued to healthcare providers and other stakeholders. The letter asks for advice on how to improve the current fee-for-service system and seeks responses to three questions:

  • What specific reforms should be made to the physician fee schedule to ensure that physician services are valued appropriately?
  • What specific policies should be implemented that could co-exist with the current FFS physician payment and would identify and reduce unnecessary utilization to improve health and reduce Medicare spending growth?
  • Within the context of the current FFS system, how specifically can Medicare more effectively incentivize physician practices to undertake the structural, behavioral, and other changes needed to participate in alternative payment models?

 

The Senators stress that comments containing specific suggestions will be of the most value as work continues on physician payment reform. Comments should be submitted to sgrcomments@finance.senate.gov by May 31, 2013 and for questions and information, call (202) 224-4515.