Posted 11/16/11 on The Health Affairs Blog
Copyright ©2011 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.
The Medicare Payment Advisory Commission (MedPAC) is the closest thing Congress has to adult supervision on important health policy questions. The Commission commands bipartisan respect both for its record of sound policy advice and for its leadership.
With its October recommendations, MedPac attempted to solve the sustainable growth rate (SGR) physician payment formula budget crisis by spreading its more than $300 billion cost beyond the physician community. More than two-thirds of the burden would fall on hospitals, pharmaceutical and device manufacturers and, significantly, on Medicare beneficiaries themselves. Clearly MedPac’s intent was to widen the circle of pain.
Continue reading “MedPAC’s SGR Solution: Bad Medicine For A Chronic Problem”
Posted 11/7/11 on Health Blawg
CMS issued the final MPFS — the Medicare Physician Fee Schedule for 2012 — this past week. The key feature of the rule, for many folks, is the Sustainable Growth Rate-(SGR)-mandated 27.4% cut in Medicare professional serivces reimbursements. We now get to watch the drama unfold over the next eight weeks, as the MedPAC proposal to replace the SGR is bandied about, and the machinations of the supercommittee tasked with brokering a budget fix either do or do not get us closer to a reasoned approach to doing more with less. The MedPAC idea is to drop the RBRVS conversion factor for specialty care payments 5.9% per year for two years, then hold it steady for 8 years, while keeping the primary care conversion factor flat for 10 years. The net effect: physician payments will “only” double over the next 10 years. (One clever idea squirreled away in the MedPAC report is that savings in the Medicare Shared Savings Plan (ACO) should be measured against a baseline of what Medicare would have spent on the care absent the changes in the proposed SGR fix — i.e., a higher baseline, with greater potential savings. Another 50 clever ideas like this and we’ll be talking about saving some real money.)
Continue reading “The 2012 Medicare Physician Fee Schedule is Finalized”
Regular readers will know that I have been part of a campaign to make the impacts of the RUC known, to urge primary care physicians to demand that their medical societies abandon participation in the RUC, and to encourage employer groups to collaborate with primary care in opposing it.
An ally in this effort is Rep. Jim McDermott (D-WA), a psychiatrist, who recently published an important article in New England Journal of Medicine, Harnessing Our Opportunity to Make Primary Care Sustainable, that made a forceful argument for replacing the RUC. In this video, Rep. McDermott questions Glenn Hackbarth, JD, the Chair of the Medicare Payment Advisory Commission (MedPAC) about the RUC’s corrosive practices.
BTW, the chart that Rep. McDermott shows at the outset is the one developed for our site, Replace the RUC.