Four former administrators of the Centers for Medicare & Medicaid Services were all in agreement last week: The sustainable growth rate (SGR) formula for physicians is completely broken and needs to be replaced, reported Kaiser Health News.
Gail Wilensky, Bruce Vladeck, Mark McLellan and Thomas Scully all testified in front of the Senate Finance Committee on May 10 that the current SGR is completely unfeasible.
"There is no reward for efficiency, no reward for quality, and no link to how physician practices (operate)," Wilensky said, according to KHN video footage.
The SGR, introduced in the late 1990s, has never really functioned to keep a lid on escalating Medicare payments to physicians. Instead, the formula has made physicians subject to double-digit rate cuts in recent years--including a pending 30 percent cut in 2013--prompting Congress to pass temporary "fixes" to the program while a permanent solution is found.
Currently, bipartisan legislation put forth by the U.S. House of Representatives would introduce more payment flexibility, with money going to practices depending, in part, on geography, specialty and practice type, reported The Hill's Healthwatch.
Among the fixes proposed by the former CMS chief, McLellan suggested more use of bundled payments--as is the case with the various accountable care organization pilots, according to the KHN video. "It's up to this committee and leaders of Congress to make a change," McLellen said.
For more:
- view the Kaiser Health News video
- read The Hill's Healthwatch blog post