SGR: Déjà vu or permanent change?

Apple-picking. Extra layers. Halloween candy on sale to buy, eat and repurchase on Oct. 30 or so (admit it!). And you know what that means is right around the corner: another massive threat to physician pay.

The numbers are haunting indeed. Even though Congress approved a 2.2 percent increase to avert a 21 percent pay cut for physicians in June (albeit after physicians had already begun to feel the pain), when the temporary fix runs out Nov. 30, physician rates are scheduled to decline 23 percent on Dec. 1, an additional 6.5 percent in January 2011 and 2.9 percent more in 2012.

With the clock ticking, the AMA is urging the National Commission on Fiscal Responsibility and Reform, a bipartisan debt commission created by President Obama in February, to consider sending Congress a proposal to repeal the SGR formula before lawmakers recess in early October to head home for the November midterm elections, American Medical News reports.

Frustrated with the longstanding "Band-Aid" approach, the AMA and other physician groups want Congress to scrap the SGR permanently and replace it with a pay system that more directly tracks the Medicare Economic Index (MEI), an annual measurement of medical inflation.

As we reported in the spring, a long-term SGR fix, conspicuously absent from this year's landmark health reform legislation, gets more expensive the longer it's postponed.

But in an election year, physicians such as Dennis Mayeaux, MD, president of the Florida Academy of Family Physicians, have their doubts that change will be swift. In a recent editorial for the Sun Sentinel, Dr. Mayeaux wrote, "in this political climate, the $210 billion price tag for such a solution will probably prevent a permanent solution this year."

And while lawmakers and physician groups held a meeting of the minds yesterday in a payment-reform discussion hosted by The Hill, until some agreement is reached regarding concrete solutions, it is unclear how the future will unfold.

In March, Medscape Today published what amounts to a disaster plan for practices to follow as they hunker down for hurricane-force cuts. Whether the next storm will hit in its full 30-percent-cut force or blow out to sea, it's a good time (in fact, there's never a bad time) for practices to get vigilant about billing and collections, streamline work processes, scrutinize overhead and explore other sources of revenue.

What steps has your practice taken to shore up against uncertainty? - Deb