The House Energy and Commerce Committee voted 51-0 to approve legislation (HR 2810) that would gradually repeal the sustainable growth rate (SGR). The bill will now head to the full House for consideration.
Under the proposal, Medicare physician reimbursements would grow by 0.5% annually over five years. Starting in 2019, Medicare would switch to an enhanced fee-for-service system that would provide physicians with updates and payment incentives based on their performance on certain quality measures. The quality measures would be based on:
- Care coordination;
- Clinical care;
- Patient experience;
- Patient population; and
The legislation also directs HHS Secretary Kathleen Sebelius to review and finalize the quality measures each year, develop codes for complex chronic care management services, and develop a fee schedule for those services starting in 2015. The bill would allow physicians to opt out of the fee-for-service system and choose an alternative payment model that emphasizes efficient and quality care, such as: accountable care organizations, bundled payment programs; or patient-centered medical homes.
However, the proposal still does not include full details on how it would offset the cost of repealing the current payment system. The Congressional Budget Office has estimated the total cost of repealing the SGR would be $139.1 billion over 10 years.
Additionally, the Senate Finance Committee recently held a closed-door meeting to discuss its own bipartisan ‘doc fix’ legislation. The Committee hopes to introduce the proposal after the August recess.