The demise of the Medicare Sustainable Growth Rate formula is a step closer to reality as the House Energy and Commerce Committee voted unanimously July 31 in favor of legislation that would remove the formula.
Both Democrats and Republicans on the committee supported the Medicare Patient Access and Quality Improvement Act of 2013 in a 51-0 vote. The legislation, H.R. 2810, was authored by Rep. Michael Burgess (R-Tex.), and developed with input from physician organizations.
Alicia Ault/IMNG Medical Media
Rep. Michael Burgess
If enacted, the legislation would replace the SGR with a 0.5% payment increase for physicians from 2014 through 2018. It would continue to support fee-for-service medicine, but also encourage the formation of new delivery models and reward reporting of quality data.
"In harnessing the ideas of the medical profession, and working as a team with Energy and Commerce Democrats as well as Ways and Means Republicans, we have crafted a policy that will not only get out of committee but has the merits to make it to the president’s desk," Rep. Fred Upton (R-Mich.), chairman of the Energy and Commerce Committee, said in a statement.
Rep. Henry Waxman (D-Calif.), the committee’s ranking minority member, said, "What is obvious today is that we have a bipartisan commitment to try to solve this problem. And that when we decide to work together, we can achieve positive results." He also noted that "in more than a decade of saying something needs to be done, I’m pleased that this committee is the first to act to bring this issue to the forefront."
The American College of Physicians said it was mostly pleased with the legislation and its progress. In addition to rewarding physician efficiency, "the bill promises to accelerate the growth of patient-centered medical homes, an innovative primary care delivery model that has been shown to improve outcomes and lower the costs of care for patients across the country," said Dr. Molly Cooke, ACP president, in a statement.
The college "looks forward to continuing to work with the House and Senate on a bipartisan basis to get legislation enacted this year that includes these and other key elements of the House Energy and Commerce Committee bill, plus additional improvements needed to accelerate the movement toward high-value, patient-centered health care."
The American Medical Association and the American Academy of Family Physicians also support the legislation. When the bill was approved by the Energy and Commerce Health Subcommittee, the AAFP said it was disappointed that the bill did not have higher payments for primary care.
During those deliberations, the AMA, AAFP, ACP, and some state medical societies also told the committee that a provision addressing misvalued codes could end up cutting physician pay. They’ve asked the committee to consider an amendment that would remove the misvalued code provisions from the bill; such an amendment was not considered by the committee.
The legislation still has a long path to passage. The House Ways and Means Committee and the Senate Finance Committee have also been working on legislation to replace the SGR. And so far, legislators in both houses have not addressed how to pay for an SGR fix.
Several Energy and Commerce Committee members acknowledged the looming financial reality during deliberations.
"One of the largest hurdles to overcome will be how to pay for the cost associated with fixing the SGR," said Rep. Eliot Engel (D-N.Y.). He urged his colleagues to continue the spirit of bipartisanship when figuring out the cost of replacement.
"We know that the work is not done," said Rep. Phil Gingrey (R-Ga.). "Any fiscally responsible bill in today’s budgetary environment must be paid for. I look forward to finding offsets that do not impact the practice of medicine but instead focus on good governance and combating waste," said the congressman, who is also an ob.gyn.
That work will likely come in September, when Congress returns from its summer recess.
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