Lawmakers Revise SGR Repeal Proposal, Scale Back Penalties; Another Short Term “Doc Fix” Likely Until Early 2014

Discussion Draft to repeal Medicare's sustainable growth rate (SGR) payment formula. The changes followed feedback from physician groups and include physician-favorable modifications to the October version. The revised draft includes scaling back the Value-Based Performance (VBP), the amount of payment that is contingent on performance. This phase-in approach, according to the drafters, "allows professionals time to adjust to the single consolidated incentive program." The maximum upside adjustment also decreased to the revised proposal numbers.   The updated draft bill also calls for subjecting non-physicians, such as nurse practitioners and physicians assistants, to the VBP program in 2017, instead of beginning in 2018. The updated draft gives professionals credit for year-to-year improvement in the determination of their "quality and resource use performance category score." The Committee staff hoped this responded "to the concern that assessing performance only on achievement pits professionals against each other." The new model also drops the 10% penalty for doctors who do not report cost data. The updates still seek to ensure accurate valuation of the physician fee schedule by retaining incentive payments for proper data collection. The modifications invest more money in encouraging Alternative Payment Model (APM) participation. The first draft included $50 million over five years, and now the funding is set at $25 million, each year, over five years. Furth...
Source: Policy and Medicine - Category: Health Medicine and Bioethics Commentators Authors: Source Type: blogs