The Senate Finance and House Ways and Means Committees released last week a discussion of their proposal to fix the sustainable growth rate formula, which is used by Medicare to reimburse healthcare professionals and institutions.
The proposal would prevent cuts to the SGR—estimated at 24 percent for 2014—but would not increase payments through 2023, The National Law Review reports.
Beginning in 2024, healthcare professionals who opt for advanced alternative payment models that involve two-sided risk and measure the quality of provided care will be eligible for a two percent update, while other healthcare professionals would only receive a one percent update. Providers who get a significant part of their revenue from APMs would be eligible for bonus payments.
Additionally, the proposal would make penalties that would have been assessed under quality incentive programs available to professionals who have proven their ability to deliver high-quality care. The proposal also contains language to encourage providers to coordinate care for individuals with chronic care needs, according to The National Law Review.
The Bipartisan Policy Center commended the committees for releasing the proposal.
“It is an all too familiar refrain in Washington, D.C.,” BPC Senior Vice President Bill Hoagland said.“What will we do to fix the SGR? The more skeptical among us suggest that the most likely scenario is yet another one-year patch on the problem. However, we strongly encourage Congress to take advantage of this bipartisan and forward-thinking momentum and act now to replace the SGR with more meaningful reforms. Costs associated with this approach should also be fully offset in a thoughtful way that can garner bipartisan support.”
The proposal draft has also received positive feedback from the House Energy and Commerce Committee, and the American Medical Association and American Medical Group Association are currently reviewing the proposal, The National Law Review reports.