Groups Call For Permanent Fix For Doctor Payment Formula

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National groups are calling for a permanent solution to the doctor payment formula and warning about a possible shortage in doctors and impending decline in Medicare payments. The Virginian-Pilot reports: "If Congress doesn't intervene, a funding formula will trigger a 21 percent cut in reimbursements to doctors in the Medicare and Tricare programs on March 1, a group of national organizations warned Thursday. That, the group said, will force doctors to drop out of the programs and make it tougher for elderly and military beneficiaries to get health care. Representatives of the groups -- AARP, the American Medical Association and the Military Officers Association of America -- appeared in a videoconference from five cities, including Norfolk" (Walzer, 1/22).

Wisconsin Radio Network reports that Ardis Hoven, the AMA's board chair-elect, told reporters that under the current payment system doctors are not keeping up with the cost of care and that as the Baby Boom generation moves into Medicare the pressure on doctors could become much worse and force more physicians to refuse to take Medicare patients. She also said "'military families' access to health care would also be threatened, because their coverage under TRICARE is based on Medicare rates. Hoven says it would cost about $210-billion to fix the payment system right now, but in four to five years, it will jump to $350-billion" (Johnson, 1/21).

Modern HealthCare reports: "Medicare's sustainable growth rate, or SGR, formula is based on the economy's health and has threatened cuts to physician payments every year since 2003. Congress has stepped in each time to prevent those cuts from occurring. Physicians face a 21.2% cut at the end of February unless Congress intervenes again. The Senate next week is expected to vote on a debt-ceiling bill that could possibly contain a permanent fix to the SGR. Legislation to revamp the SGR cleared the House in a stand-alone bill last November" (Lubell, 1/21).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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