All Clarivate websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.

More information on our cookie policy.

BioWorld. Link to homepage.

Clarivate
  • BioWorld
  • BioWorld MedTech
  • BioWorld Asia
  • BioWorld Science
  • Data Snapshots
    • BioWorld
    • BioWorld MedTech
  • Special reports
    • Aging
    • Artificial intelligence
    • Coronavirus
    • IVDs on the rise
    • Top Biopharma Trends of 2021
    • Top Med-tech Trends of 2021
    • Premium reports
      • BioWorld Financings Reports
      • Disease Incidence & Prevalence Summaries

BioWorld. Link to homepage.

  • Sign In
  • Sign Out
  • My Account
Subscribe
BioWorld - Wednesday, August 10, 2022
Home » Blogs » BioWorld MedTech Perspectives » Congress and the doc fix: Is 2013 the year?

BioWorld MedTech Perspectives
BioWorld MedTech Perspectives RSS FeedRSS

BioWorld MedTech

Congress and the doc fix: Is 2013 the year?

Feb. 18, 2013
By Mark McCarty
No Comments

A clumsy attempt to address the Medicare Part B physician fee problem has nagged at Washington for a decade, but it appears Congress is ready to put a doc fix in play. Whether it’ll happen depends on politics and, as a skeptic might argue, some accounting sleight-of-hand, but it appears this is a now-or-never moment.

As has been widely noted, the Congressional Budget Office recently released a report proposing a lower figure for the budgetary effects of a repeal of the sustainable growth rate (SGR) mechanism than has been calculated for some time.

Instead of the average figure of $30 billion a year that had been floated a few years ago, CBO claims the figure now stands at roughly $14 billion a year over 10 years. A recent hearing in the House Energy and Commerce Committee makes clear the bipartisan support for a repeal of SGR is as intense as it has ever been, and one has to assume a bill will at least make it through committee.

Among the potential flashpoints in the House is the question of offsets. Rep. Frank Pallone of New Jersey resurrected the idea of using cuts to military spending in Iraq and Afghanistan as an offset, but we should acknowledge that the pay-for question might come across as background noise. Congress may simply resort to the path of least resistance.

Two sources of fudged numbers

There are a couple of points to consider. One is that the current low rate of growth in Medicare expenditures is an anomaly and will vanish as the economy recovers, which means the historical cost growth of 5-6% will resume. This tells us the fiscal claims underlying the current push rely heavily on a bookkeeping convenience, but that’s how accounting is routinely (ab)used.

The second point is that as physicians increasingly become tied to hospitals under accountable care organizations, some spending that has been treated as a Part B expense will fall into Part A, the Medicare hospital silo. This, too, suggests that any easing of physician fee spending could be more apparent than real. It also means Part A is almost certain to balloon and become the new problem child on Capitol Hill.

Perhaps most interesting for physician specialists – beyond the recent Part B fee schedule that shifts resources to primary care at the cost of specialty care – is the rumor that an SGR repeal bill will call for permanent zero updates to the Medicare physician fee schedule (MPFS) within two or three years of that bill’s passage. The message there is clear to specialists and primary care docs alike: Get on board with ACOs or get out of Medicare altogether, because you’d starve under Part B fee-for-service.

So what does it mean if this happens? Basically it’s one item off a hefty to-do list where Medicare spending is concerned. Getting rid of the loathed SGR will remove a perennial headache for both sides of the political aisle and will once again “prove” that Congress can act in a bipartisan fashion, but repealing SGR will do pretty close to nothing to “bend the cost curve.” Not by itself, anyway.

You must login or register in order to post a comment.

Report Abusive Comment

Popular Stories

  • Free access to BioWorld coronavirus articles

    BioWorld
    The articles in this collection are from BioWorld’s ongoing coverage of the COVID-19 coronavirus pandemic. They are available for free with registration. Note...
  • Today's news in brief

    BioWorld
    BioWorld briefs for Aug. 9, 2022.
  • Today's news in brief

    BioWorld MedTech
    BioWorld MedTech briefs for Aug. 9, 2022.
  • Amvuttra

    Alnylam’s Amvuttra rare disease drug among positive recommendations from Europe’s CHMP

    BioWorld
    Alnylam Pharmaceuticals Inc.’s Amvuttra (vutrisiran), a treatment for the rare disease hereditary transthyretin-mediated amyloidosis, was among medicines...
  • Pig organ cells

    Whole body cellular function recovery in pigs after death

    Science
    A new system for restoring cell function and tissues in mammals after death could expand the availability of organs for transplantation. The research also opens...
black cortellis ad

BioWorld Premium

Enjoy extended coverage for the most complete market view with BioWorld, BioWorld MedTech, and BioWorld Asia in a single, easy to access subscription.

Subscribe
  • BioWorld
    • Today's news
    • Analysis and data insight
    • Clinical
    • Data Snapshots
    • Deals and M&A
    • Financings
    • Newco news
    • Opinion
    • Regulatory
    • Science
  • BioWorld MedTech
    • Today's news
    • Clinical
    • Data Snapshots
    • Deals and M&A
    • Financings
    • Newco news
    • Opinion
    • Regulatory
    • Science
  • BioWorld Asia
    • Today's news
    • Analysis and data insight
    • Australia
    • China
    • Clinical
    • Deals and M&A
    • Financings
    • Newco news
    • Regulatory
    • Science
  • BioWorld Science
    • Archives
    • Today's news
    • Search BioWorld Science
    • About
  • More
    • About
    • Archives
    • Article reprints and permissions
    • Contact us
    • Cookie policy
    • Copyright notice
    • Data methodology
    • Podcasts
    • Privacy policy
    • Share your news with BioWorld
    • Staff
    • Terms of use
Follow Us

Copyright ©2022. All Rights Reserved. Design, CMS, Hosting & Web Development :: ePublishing