US needs a sustainable Medicare

For the millions of Americans nervously hoping that a sound Medicare program will still be available to them by the time they reach their “golden years,” they just may be in luck.

Congress has made real progress on reforms that could modernize the Medicare program and help usher in a new era of access to high-quality healthcare for seniors and sustainable practice environments for the physicians who care for them. Pending legislation includes important provisions that represent improvements over current law governing quality reporting and pay-for-performance programs.

The American Medical Association strongly supports the patient-centric, fiscally responsible Medicare policy that has bipartisan and bicameral support, and Congress should prioritize this legislation and take action to reform and strengthen the program for America’s seniors.

{mosads}Congress can build on the progress made over the last year and a half, and act now to end the vicious cycle of expensive, short-term patches that have yet to address the underlying problem — the failed sustainable growth rate (SGR) formula. Now is the time to pass a long-term solution to the SGR and move toward a more stable Medicare physician payment policy.

For more than a decade, the SGR cycle has compromised access to care for our nation’s seniors and disabled while repeatedly threatening unmanageable payment cuts to physicians and prompting $154 billion worth of short-term Congressional patches — 16 in all.

Unless Congress enacts SGR repeal legislation by March 31, the physicians who care for Medicare patients will face an across-the-board Medicare payment cut of 24 percent beginning on April 1. Congress must act swiftly to reform our Medicare system before this fiscally advantageous opportunity is gone.

Physicians, patients and taxpayers have been held hostage by the SGR and a decade of instability and financial uncertainty that have given many physicians no choice but to reduce the number of Medicare patients they see and to delay investments in new equipment and innovative practice models that would enhance the delivery of high-quality, cost-effective care.

But in recent months, real momentum has been made to create a more favorable environment for medical services for America’s seniors. With rare and overwhelming bipartisan and bicameral congressional support for repealing the SGR currently in play, and the cost of fixing the problem at an all-time low, Congress has a very real opportunity to reform Medicare’s troubled payment system.

Groundbreaking innovations and pilots, many led by physicians, are already underway in Medicare and the private sector that can guide further development of improved Medicare delivery and physician payment systems. For example, accountable care organizations are allowing physicians and other healthcare providers to partner in improving care and reducing unnecessary costs. Patient-centered medical homes are working to coordinate each patient’s care, and an array of payment bundling options are compensating providers by the episode rather than for each service. These are just a few of the innovative approaches that are allowing physicians to lead changes in care delivery while being rewarded for enhancing the quality and value of patient care.

With 49 million Americans currently enrolled in Medicare and 10,000 seniors aging in each day, Congress must seize this opportunity to put the Medicare program on a better track. We urge Congress to act swiftly to put an end to the SGR once and for all — our country’s seniors cannot afford to wait any longer for Medicare to be fixed.

Hoven is president of the American Medical Association.