Goodbye SGR, Hello MACRA

How will CMS’s new physician payment policy impact emergency physicians? For nearly twenty years the debate in Washington surrounding physician payment policy revolved around the SGR, or the Sustainable Growth Rate. That all changed last year when Congress passed the Medicare Access and CHIP Reauthorization Act, commonly referred to as “MACRA” in and around the beltway. Many refer to MACRA as the “SGR-fix,” but in reality the legislation has much broader implications. It will not only change reimbursement rates but the entire payment formula and incentives for virtually every physician in the US. The SGR was created as part of the Balanced Budget Act of 1997 to control the costs of Medicare payments at a time when physicians advocated for fee-for-service payments to keep up with inflation. In the subsequent years, however, healthcare costs outpaced inflation every year requiring physicians to lobby Congress every single year to authorize additional funds to avert payment cuts. The gap in payment grew to over $170 billion as the compounded costs of healthcare inflation accumulated. Millions of dollars and thousands of hours were spent on this physician payment policy version of Groundhog’s Day each year—we marched on Capitol Hill, Congress passed a legislative Band-Aid referred to as the “doc fix,” and hollow promises were made to fix the system. Exit SGR, Enter MACRA In exchange for the SGR, we have MACRA. And this is the way it will work. Until 2019, all ph...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news