Physician groups weigh in on bill to overhaul Medicare payment system

With the SGR in the rear-view mirror, organized medicine weighed in on the historic overhaul of Medicare physician payment.

Not only does the bill, known as the Medicare Access and CHIP Reauthorization Act of 2015, replace the SGR with 0.5% payment increases in physician reimbursements from now until 2019; it also creates the Merit-based Incentive Payment System (MIPS), which consolidates PQRS, VBM and MU into one payment program beginning in 2019. Starting in 2019, physicians will either recieve payments through MIPS or a value-based Alternative Payment Model (APM).

In a conference call the day after the vote, James L. Madara, MD, CEO and executive VP of AMA, expressed approval on behalf of the nation's largest physician organization.

“The uniform conclusion was that this was not just an improvement, but a significant improvement over the current sets of measurements, whether they be VBM, PQRS or MU,” Madera said in a media conference call. “Those collections of measures were developed in a well-meaning, but somewhat disconnected way. They’ve been applied, they have lots of problems, and harmonizing them into a more cohesive group, as is done in the MIPS provision in the bill, is something we are gratified by and support.”

Madera said the SGR debate has taken some attention away from the progress that has been made in regard to reimbursing physicians for the care they provide.

“This issue of SGR, which we’ve been working on for a long time, sometimes overshadowed the fact that we’ve worked equally hard toward improving payment delivery systems, providing and identifying a series of promising models that physicians could use,” he said to the media. “This allows a brighter light to be shined on these other elements of moving payment delivery and quality forward toward lower costs and better health for our nation.”

Looking back at the annual nail-biting ritual of SGR overrides since 1998, Bibb Allen, MD, FACR, chair of the ACR Board of Chancellors, said this new legislature is necessary, but still far from finished.

“Previous short-term SGR fixes have too often been paid for out of technical component reductions in diagnostic imaging. It is long past time to put some stability into the physician payment system,” Allen said in a press release. “However, infinite policy details must be worked out to ensure it is implemented appropriately.”

Madera expressed similar sentiment, saying the AMA will follow the bill’s implementation very closely.

“Anytime a complex bill that is as helpful as this one is passed, there are implementation problems that sometimes arise,” Madera said. “One of the areas we will be strongly attentive to at the AMA is keeping our finger on the pulse of the implementation and working with the federal government to make sure this tracks in the correct way.”

The bill also includes two years of funding for the Children’s Health Insurance Plan (CHIP) and $7.2 billion for community health centers over the next two years.