Congress Agrees on Legislation to Replace SGR Formula
(HealthDay News) — Congress has agreed on legislation to repeal the Sustainable Growth Rate (SGR) formula, which will guarantee Medicare providers annual 0.5% reimbursement increases as new payment models are introduced, according to an article published February 11 in Medical Economics.
According to the article, the legislation also established the Merit-Based Incentive Payment System, overhauling current incentive programs. The new program will combine Meaningful Use, the Physician Quality Reporting System, and the Value-Based Modifier program. The new program will base physician assessments on quality, resource use, electronic health record meaningful use, and clinical practice improvement, focusing on value over volume.
In addition, the article notes that practices that move toward alternative payment models such as Patient-Centered Medical Homes will be eligible for a 5% bonus. In 2018 to 2019, practices will be required to receive 25% of their Medicare income via alternative payment models. The legislation will also establish a Physician Compare website to allow patients to research data on quality and care, and allow clinical data registries to purchase data relating to patient safety and quality metrics.
"Doctor's groups, including the American Medical Association, the Medical Group Management Association, the American College of Physicians, and the American Academy of Family Physicians, are expressing optimism that the new legislation will be a step in payment reform that pays physicians for quality instead of quantity," the article states. "The legislation must still be passed by both houses of Congress and signed by President Barack Obama before it becomes law."