AMA Debates Medicare Payment Reform as Congress Considers Ending the SGR

There was widespread support in the AMA House of Delegates for a resolution to call on the AMA to continue advocating for the repeal of the Sustainable Growth Rate (SGR) component of the Medicare formula for physician payment, while upholding the AMA’s principles of pay-for-performance, which were adopted in 2005. The resolution further urges that the AMA advocate with the Centers for Medicare and Medicaid Services (CMS) and Congress for “alternative payment models, developed in concert with specialty and state medical organizations, including private contracting as an option.”

The resolution, which was debated in reference committee hearings yesterday at the AMA Interim Meeting, will be voted on by the House of Delegates today. Repeal of the SGR has been one of APA's and the AMA’s top legislative priorities. For close to a decade the formula has required increasingly severe cuts in physician pay, which have been averted by Congress usually at the end of each year; but each year the Medicare program’s debts have accumulated because of the congressional postponement. The resolution was drafted by a coalition of state delegations in response to news from Capitol Hill that a legislative proposal was in play to end the SGR—but with significant cost offsets to help pay for the accumulated debt, including a possible 10-year freeze on physician pay. In her opening address, AMA President Ardis Hoven, M.D., urged delegates not to reject the legislative proposal while it was still in draft form. “[W]alking away [from negotiations] now would be a colossal mistake….To walk away now before we know what modifications may be made would be ill advised.“

Look for further coverage of this issue in upcoming editions of Psychiatric News. For more information about AMA’s pay for performance principles see the Psychiatric News article, “Pay for Performance Must Be Quality Issue, AMA Says.”