Proposed three-year doc fix helps primary care, puts off SGR

With just days left to avert the planned 21 percent cut to Medicare physician pay, Congress has proposed a new three-year fix that would for the first time pay more for general (primary) care than for specialty care, yet maintain the status quo of putting off fixing the sustainable growth rate formula a little longer.

The proposal, released Thursday as part of a broad jobs and tax bill, would increase payments to doctors by almost $60 billion over three years to offset the planned cut. A final vote is expected this week.

Specific elements of the proposed extenders bill include:

  • A 1.3 percent Medicare payment update for the remainder of 2010
  • A 1.0 percent payment update in 2011
  • Updates for 2012-13 established under two expenditure targets, under which primary care and preventive services doctors would get an additional raise equal to the gross domestic product at the time plus 2 percent and other doctors would get a raise of GDP plus 1 percent
  • The SGR formula resuming in 2014 to reflect current law

Although the American Academy of Family Physicians said the "bonus" to primary-care physicians could help encourage medical students to choose the field, the American Medical Association expressed regret that Congress once again failed to permanently overhaul the SGR formula.

"It's fortunate that Congress has taken some action but this is a problem that has to be solved," said Chip Kahn, president of the Federation of American Hospitals, who also expressed relief that the bill would extend the temporary increase of Medicaid funding, or the Federal Medical Assistance Percentages, for another six months.

In sum, AMA President J. James Rohack, MD, called the latest proposal a treatment for the symptoms rather than a cure for the disease.

To learn more:
- here's the AMA blog post
- read this article on Politico

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