AGA Washington Insider

A policy blog for GIs

Committee Hearings Held on SGR Reform

United States Capitol, Washington DCBoth the House Ways and Means Committee and the Energy and Commerce Committee recently held hearings on Medicare physician payment reform. The debate focused on the need to replace the sustainable growth rate (SGR) formula and transition physicians to a more value-based system under which payments will be tied to quality outcomes and efficiency.

Both House committees have jurisdiction over Medicare Part B, which covers physician services, and have been working together to develop a reform proposal. The House Energy and Commerce Committee recently drafted legislative language on how physicians would be transitioned to different phases post-SGR repeal. Since the committee is seeking feedback from physician stakeholder groups, AGA and the Alliance of Specialty Medicine will meet with them to provide input into their process.

On the other side of the Capitol, the Senate Finance Committee also held a hearing on repealing the SGR. The committee recently solicited feedback from the physician community with a series of specific questions as to how we could change the current Medicare system to better reflect the value of physician services and how to transition physicians to a more value-based system. The AGA provided feedback to the Finance Committee and highlighted our experience with quality improvement initiatives with both private payors and Medicare.

The Congressional Budget Office (CBO) recently provided a score for repealing the SGR at $139 billion over ten years. The House committees have incentive to move Medicare physician payment legislation through the process before August when CBO is expected to release a new score, which could be higher. Although both Democrats and Republicans agree on the general approach of moving away from the current fee-for-service model, the challenging debate will come when they try to determine how to pay for the reforms. The committees want to try to craft the right policy before determining the “pay-fors,” which in years past has killed any effort at a long term proposal.

The AGA is closely monitoring this critical issue for gastroenterologists and their patients. We will continue to prepare you for the changing health-care system by providing you with the tools you need to survive and thrive in this new payment climate. Look for more updates on Medicare payment reform on the AGA Washington Insider and AGA eDigest.

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