Home Forums Discussions General Discussion SGR Fix.... ? the end of Meaningful Use

The next couple of months may bring the end of the annual threat of a 20%+ cut in Medicare reimburesement:
"I would not break out the champagne just yet...still, the announcement today that House and Senate lawmakers have reached an agreement to eliminate the sustainable growth rate formula in the current payment system and replace it with one based on quality measures and new reimbursement systems could signal the beginning of the end to a decade-long policy quandary in which doctors annually face reimbursement cuts.
The agreement between the Senate Finance Committee and the House Ways and Means and Energy and Commerce committees would repeal the SGR and provide physicians? a 0.5 percent payment update each year for five years while doctors transition to a new payment system."
http://www.bna.com/house-senate-lawmakers-b17179881952

But the biggest news may be major changes (or the end!) of MU and PQRS:
"According to a summary provided by the committees that crafted the proposal, the ?payment implications? of the current incentive-payment programs would end at the end of 2017. That means Medicare would eliminate scheduled reductions in Medicare reimbursement in the form of 3% penalties for failing to comply with the meaningful-use criteria, as well as escalating penalties up to 5% in 2019. The 2% penalty for failure to report PQRS quality measures in 2017 would be dropped, too. "
http://www.modernhealthcare.com/art...l&utm_campaign=hits&utm_name=top

It is hard to know exactly what this means- or what the final form will be, but it sounds like those who don't do MU would be penalized in 2015-17, but after that the penalties would end.

Nothing to see here folks. Please move on. It's all over.

MU likely will just be lumped into newer performance criteria. So instead of simplifying payment, the new fix just cements the cognitive/procedural pay disparity and volume driven waste. Then it layers a trivial bonus (or penalty) on top, requiring even more record keeping. Gee, what a good idea! From the guys that brought us the healthcare.gov website.

At least we'll have some new gubbermint slogan-isms to make fun of. Like "Medicare Shared Savings" and "fee for value"

Since I can't paste into the post, and also because I am otherwise tied up, I will just post the link. But this could be big news. Essentially, MU and PQRS penalties would end in 2017, which completely changes the calculation as to whether to participate or not (in my opinion).

http://www.modernhealthcare.com/art...ium=email&utm_campaign=hits&utm_name=top

There are several intriguing threads in that article, and it will be interesting to see what this all actually turns out to be.

What the article doesn't mention, but may be part of this as a political calculation is that there are some markets where Doctors and Providers have opted out of government payer participation at a rate that is causing insurer/governments to offer "incentive" $$$ to get folks to opt back in.

Apparently it worries The Powers That [currently] Be when they dictate a plan and Doctors won't participate.

I agree. Although we'd all like to see the interminable SGR threat go away, there is no revenue source to replace these cuts, which will be a nonstarter in the House. And for those of us who aren't keen for "new payment models", there is only 0.5% increase/year, versus the already in place 2% sequester reduction (which very quietly was just extended to 2023).

One step forward, two steps back IMHO.

As a guy who needs only the tiniest of incentives to retire, let me just say it is a lot of fun to watch the game of whack-a-mole being played out. For the moment, I still think medicine is wonderful, and really like going in to work to interact with my patients. I would hope everyone else could feel the same.

SGR will include MU and more. I agree with ryanjo. "Quality" measures are not going anywhere. That's the deal: SGR fix in exchange for permanent fed control over our "quality and value" measures.

There's no free lunch. They are trying to squeeze more value out of primary care when the big cost savings are in cutting hospital/procedure/specialist fees. We don't need SGR fix for fed control. Just cut hospital/procedure/specialist reimbursement and preserve primary care revenue.

NYT series is excellent:
http://nyti.ms/19CWN1i
http://nyti.ms/1bETkiS

Larry
Solo IM Cincinnati

*Like* Unfortunately, I still need to get 20 years of hay out of this field. I hope my patients and I can survive it all.

Yep unless Lotto comes through I'm dreading 2017 and potential 10-12% decreased Mmedicare/Medicaid reimbursements because I refuse to be a data collector for Unk Sam