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Friday Oct 28, 2011

How Family Physicians Can Help Solve the SGR Issue

In 2010, Congress put five temporary patches on the sustainable growth rate, or SGR, part of the flawed formula that CMS uses to set Medicare payment rates for physician services.

If Congress does not act again by Dec. 31, our Medicare payments will be cut by nearly 30 percent. Though Congress has delayed such cuts at least once a year since 2002, family physicians should not have undue confidence that our legislators will do so again.

A few months ago, Congress formed the bipartisan Joint Select Committee on Deficit Reduction. This "supercommittee" is tasked with reducing the federal deficit by at least $1.5 trillion during the next 10 years. This committee represents our best opportunity in years to resolve the SGR issue.

Meanwhile, the Medicare Payment Advisory Commission, or MedPAC, recently recommended elimination of the SGR. While the AAFP welcomed that suggestion, MedPAC also recommended that Medicare freeze current payment levels for primary care services for the next decade. It also recommended cutting the Medicare payment rate for subspecialists by nearly 6 percent for the next three years, followed by a seven-year payment freeze for subspecialists.

Although we are encouraged that MedPAC acknowledges the need to treat primary care differently, the survival of our practices would be threatened by a 10-year freeze on payments.

For the first time, a Congressional advisory body is telling legislators to cut physician payment. Although the recommendation to cut payment is specific to subspecialists, the message should be of real concern to all physicians.

We cannot allow politicians to make decisions on an issue as critical as the SGR without hearing from us first. It's never been more important to fix this problem, and your Academy is asking you to help.

As part of the AAFP’s Family Medicine Matters nationwide grassroots advocacy effort, many of you will receive an e-mail from me today with links to videos about the SGR and why the uncertainty around this issue puts family medicine in peril. One of the videos is specifically intended as information for our members, while the other is a Speak Out video for you to send to your legislators.

I know you are weary of the SGR issue, but your voice is needed now more than ever. We are not asking Congress for yet another patch. We are asking Congress to do three things:

  • repeal the SGR;
  • set a payment rate for the next three to five years so that different systems can be studied; and
  • within this rate, give primary care physicians a 3 percent higher payment rate compared to that for non-primary care physicians.

As a practicing family physician, I know your time is valuable. This is your opportunity to make that exact point to Congress. I urge you to participate in this grassroots effort to protect family medicine.

We cannot afford to miss this opportunity.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.