The healthcare industry sometimes resembles that friend we all have who is always running late, and never pays his bills until the last minute. Once again,the Medicare SGR patch adopted this time last year is set to expire at the end of the month.
This year, however, lawmakers are expressing cautious optimism that a plan devised by House Speaker John Boehner and Minority Leader Nancy Pelosi might actually please both sides of the aisle. The deal allegedly would toss the SGR and reauthorize CHIP for two years at the cost of $200 billion, $70 billion of which would be directly paid for. Half of the offset would be paid for by deductibles and means-testing and half from provider cuts.
"There's a general agreement that everybody is sick and tired of these patches," House Energy and Commerce Chairman Fred Upton told The National Journal.
The tragic irony is that the new SGR formula devised by Congress is not a hotly contested partisan issue with Republicans and Democrats firing shots at each other regarding the plan. This permanent legislative fix to the SGR—which has been patched by Congress periodically since 2003—is something upon which both political parties actually agree. Moreover, the SGR, as it was devised in 1997, has been woefully out of date for the better part of a decade. This permanent fix is prudent, necessary and possesses the unique quality of already existing.
This past Monday, the AMA sent a letter to House and Senate leaders—co-signed by more than 750 healthcare organizations—urging them to bring the SGR measure to a vote before the March 31 deadline. If no fix is in place by then, the previous law will kick in, mandating that Medicare cut its payments to doctors by more than 20%, causing a ripple effect that many predict will cause the closing of thousands of medical practices and end with many seniors being denied care because of the lack of medical professionals who are able to accept the reduction in payments. In other words, yet again, the healthcare industry is faced with a legal deadline with dire consequences, a deadline only a couple of weeks away.
"We made significant progress in the previous Congress to find common ground for a Medicare fix that would establish a clear pathway for developing and implementing new healthcare delivery and payment models that improve quality, coordinate care and reduce costs," AMA President Robert M. Wah, MD wrote in a statement released Monday. "It would be a shame to once again let that solution, which took many months to develop, go to waste."
Congress must act now to avoid an entirely preventable industry-wide crisis. Healthcare faces more than a dozen major challenges in the coming year, including ICD-10, Meaningful Use, EHR security, and potential ACA subsidy rollbacks just to name a few. It's unconscionable for Congress to drop the ball on a bipartisan, bicameral solution that it has already created when there are so many other problems on the horizon that require the industry's full attention.
Upton told The National Journal that he expects the bill to be brought up in the next week—cutting it close on the March 31 deadline and conceivably putting intentional pressure on lawmakers.