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America’s Essential Hospitals Comments on SGR Fix




This week in Washington—America’s Essential Hospitals comments on a congressional proposal to fix the physician payment system. You are tuning in to the health policy update from America’s Essential Hospitals for the week of Nov. 11.

Key congressional committees announced on Oct. 31 that they came to an agreement on a proposal for fixing the Medicare physician payment system. The Medicare physician payment system is the system used to determine physician reimbursements for providing services to Medicare patients. It is based on a formula that’s intended to control overall Medicare costs. Medicare accomplishes this through the use of the sustainable growth rate.

Under the current formula, doctors face a 25 percent cut in payments for the care they provide to Medicare patients in 2014. This is because physician payments must decrease to prevent Medicare costs from growing at an unsustainable rate.

The proposal to fix the Medicare physician payment system reforms the fee-for-service payment system and encourages participation in other payment models like accountable care organizations and patient-centered medical homes.

America’s Essential Hospitals submitted comments to the congressional committees this week about this proposal. America’s Essential Hospitals supports the committees’ goal of reforming the Medicare physician payment system. The association believes that access to care is critical for ensuring that all patients can get the health services they need in their communities. In its comments, the association stated that stabilizing Medicare physician payments is an important way to help make sure that patients can see their doctors when they need them and maintain continuity of care.

Preserving essential hospital funding is another necessary component for protecting access to care. In its comments, America’s Essential Hospitals urged Congress to ensure that the Medicare physician payment solution is not financed through cuts to hospital payments. Cutting payments could prevent hospitals from providing high-quality care to their patients by forcing hospitals to cut back on vital services. The benefits of Medicare physician payment reform would be greatly reduced if hospitals are faced with payment cuts at the same time. As the association stated in its comments, it is critical that the Medicare physician payment solution strengthens the entire health care system.

America’s Essential Hospitals also supported the committees’ goal of creating incentives for doctors and hospitals to provide the highest quality care. Specifically, America’s Essential Hospitals supported the components of the proposal that encourage care coordination for individuals with complex needs and the use of value-based performance payments. Care coordination helps ensure that patients get the right care when they need it, and it is critical to ensuring that patients have a positive experience when they see their health care providers. Value-based performance payments enable providers to earn bonus payments when they provide high-quality care to patients, including doing things like effectively coordinating care and collaborating with other providers.

Thanks for listening to another edition of This Week in Washington. I’m Erin Richardson; join us next week for another health policy update.


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