Did you know that Congress has employed 16 temporary fixes to override sustainable growth rate (SGR) pay cuts over the last 10 years? The time for a permanent, workable and sustainable solution is loooooong overdue.
To that end, neurosurgery recently joined with the American Medical Association (AMA) and over 100 state and national medical societies in providing Congress with a set of driving principles and core elements for transitioning to a higher performing Medicare program. The principles are intended to serve as a foundation for a transition plan, which focuses on the need for successful delivery reforms that address patient needs and choice, investment and support for physician infrastructure, and payment updates that reflect changes in practice costs and progress on improvements. Importantly, the principles respect the concept that one-size-does-not-fit-all, noting that new delivery systems must “reflect the diversity of physician practices and provide opportunities for physicians to choose payment models that work for their patients, practice, specialty and region.” In addition, the principles “recognize the central role of the profession in determining and measuring quality” and that physicians should be credited for participating in specialty society initiatives. Neurosurgery’s own NeuroPoint Alliance (NPA) and its National Neurosurgical Quality and Outcomes Database (N2QOD) are perfect examples of how our specialty is working to provide neurosurgeons with the tools to demonstrate the quality of care that they provide to their patients.
But preventing the pending SGR cuts isn’t the only reimbursement challenge that physicians face, and earlier this year the AANS and CNS pointed this out in a letter to House Ways and Means Committee Chairman Dave Camp (R-MI). In our detailed comments on how to reform the Medicare physician payment system and improve the quality of care under Medicare, we emphasized that fundamental reform of the entire Medicare program is essential to solving the SGR problem. We also highlighted the fact that physicians face cumulative financial penalties if they do not successfully participate in multiple Medicare programs, including the e-prescribing program, the electronic health record (EHR) meaningful use program and the Physician Quality Reporting System (PQRS). These cuts are on top of the SGR and other budget deficit-related cuts, and the cumulative pay cut to physicians adds up to a whopping 85 percent over the next nine years (if you don’t believe us, see our handy dandy chart below).
Source: 2012 Medicare Trustees’ Report
This chart brings home the point that physicians simply cannot absorb cuts of this magnitude, so it is imperative that Congress act to modify these flawed programs. As we have said before: patients and physicians deserve better.