Bipartisan fix advancing for Medicare doctors' pay
A fundamental change in the budget equation has handed lawmakers a rare opportunity to repeal Medicare's broken physician payment policy, while also freeing them from having to waive billions of dollars in impending cuts every year. Slowing health care inflation has slashed the cost of repealing the old formula, bringing it down to $116.5 billion over 10 years, according to the latest estimates.
Democrats and Republicans on both sides of the Capitol plan to push ahead this week with a framework for a new payment policy. Although a final fix will have to wait for next year, the new approach would set up financial carrots and sticks for doctors to provide quality, cost-effective care to more than 50 million elderly and disabled Medicare recipients. Up to 10 percent of an individual physician's pay could eventually be linked to the doctor's performance on quality indicators.
The plan would repeal the centerpiece of the old payment formula, a 1990s budget provision that mandates automatic cuts to doctors to limit Medicare spending. It became a symbol of government dysfunction after Congress got into the habit of regularly issuing temporary reprieves. Otherwise doctors might stop accepting Medicare patients. But restoring payments to doctors each year didn't solve the problem, because the law remained on the books. A reduction of nearly 24 percent next year is called for unless Congress acts.
Experts say the old payment formula needs to go not just because it's ineffective, but also because it encourages a costly, piecemeal approach to health care. Doctors bill for as many services as they can to maximize Medicare reimbursement, but there's no consistent focus on keeping patients as healthy as possible.
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