You would win big-time if you’re a primary care practice, but lose big-time if you’re a specialist, under a new proposal by the Medicare Payment Advisory Commission (MedPAC). The group has a budget-neutral, “paid-for” solution that repeals the sustainable growth rate (SGR) formula once and for all, saving all physicians from the annual cliffhanger Medicare pay cut that Congress always steps in to prevent.
Under the MedPAC SGR offset proposal, primary care payment rates would be frozen, while all services not designated as primary care would see a 5.9% cut annually over the next three years. The total effect would be a roughly 18% pay cut to specialists over three years, and flat payment updates for primary care practitioners. This is all theoretically better than an across-the-board cut of 30% as mandated by SGR under current law, but of course history has shown that Congress doesn’t want to be responsible for slashing Medicare payments by nearly a third.
Already the physician advocacy groups are complaining about the MedPAC proposal, which actually has yet to be voted on by the actual MedPAC commission members. Only after a vote will this solution become MedPAC’s official recommendation to Congress.
That hasn’t stopped the AMA from being the first responder. “The [AMA] strongly opposes the plan under consideration by MedPAC for offsetting the cost of repealing the Medicare SGR formula,” AMA President Peter Carmel, MD, said in a prepared statement. “Repealing the SGR this year is a step that Congress must take, but doing so with these drastic cuts would be disastrous for Medicare patients’ access to care and would derail delivery innovations that are key to improving coordination and lowering health care costs.”
MedPAC will vote on whether to adopt the proposal as a formal recommendation to Congress during its next meeting, set for Oct. 6-7.