New Legislation Would Reform Medicare Payments to Providers
The American Geriatrics Society (AGS) is very encouraged by new legislation that would repeal the Sustainable Growth Rate (SGR) formula and reform the Medicare Payment System. Last week, Congresswoman Allyson Schwartz (D-PA) and Congressman Joe Heck, DO, (R-NV) introduced the Medicare Physician Payment Innovation Act of 2012. AGS has long advocated Congress to replace the flawed SGR with a more predictable and fairer system of updating physician payments, including appropriate and higher values for primary care services.
The bipartisan House bill would eliminate the Sustainable Growth Rate (SGR) formula and prevent a 30% cut in provider payments scheduled to take effect January 1, 2013. The bill would also introduce a number of payment reforms, including a 2.5% payment increase for primary care providers and better access to preventive care, care coordination, and primary care services through increased payments for those services. The legislation would additionally accelerate the testing and evaluation of new payment and delivery models, and then provide incentives to facilitate the transition to the most effective models that improve care and reduce costs.
With the population of adults aged 85 and over projected to grow at four times the rate of the rest of the population, the meaningful reform proposed by this legislation could not come at a more crucial time. This current system will further exacerbate the shortage of practicing geriatricians, as well as the shortage of advanced practice nurses and physician assistants specializing in geriatrics, at a time when our nation needs to build a healthcare workforce that is prepared to meet the unique care needs of older adults.
“Our nation already faces a serious shortage of geriatrics healthcare professionals across disciplines and the payment system, if left unchanged, will continue to discourage providers paid under the Medicare fee schedule from pursuing or continuing careers in geriatrics,” said AGS President Jim Pacala, MD. “We are concerned that current Medicare payments fail to keep up with inflation or cover many of the services -- such as care coordination -- that are integral to providing high quality care to older adults.”
“We praise the leadership of Congresswoman Schwartz and Congressman Heck on this issue and believe that this legislation is a positive, concrete step towards reforming our flawed payment system,” said Jennie Chin Hansen, Chief Executive Officer of the American Geriatrics Society. “Now is the time to invest in a new payment system that recognizes that frail older Americans are the patients who will benefit the most from transformation of Medicare into a patient-centered system focused on primary geriatric care, chronic care management and coordination of care across settings. We can and should be doing better for older Americans.“
TAKE ACTION TODAY
AGS encourages you to Take Action by visiting AGS’ Health in Aging Advocacy Center. Contact your members of Congress today, and urge them to call for both the repeal of the SGR and comprehensive Medicare payment and delivery reform.
