Medicare Payment Reform for 2009-2017

AMA House of Delegates Push for SGR Changes

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[Staff Reporters]

According to the American Medical News, November 24, 2008, the AMA House of Delegates is setting the groundwork for a major push to reform Medicare physician payment next year.

AMA Lobby

The AMA will continue to lobby Congress for changes in the sustainable growth rate [SGR] formula to better reflect practice costs, to improve the accuracy of the index that gauges increases in those costs and to investigate geographic pay disparities; among other issues.

AMA Council on Medical Service

The AMA Council on Medical Service also requested physician input on payment systems that could replace or improve the current one. These newer compensation models might include:

  • bundled payments, under which physicians are paid flat rates per episode of care, rather than per service;
  • gainsharing, under which hospitals and doctors agree to share incentive pay and savings from quality improvement;
  • medical homes, under which doctors are paid for coordinating care; and,
  • pay-for-performance, under which doctors are paid based on quality measures.

Assessment

To date, it is unclear which new compensation model[s] will prevail; if any?

Conclusion

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