Every year for more than a decade, Congress has stepped in to avert scheduled cuts to Medicare physician payments. Currently, Medicare providers face a 25 percent pay cut on January 1, 2014. In my home state of Pennsylvania alone, 2.3 million seniors could lose access to their doctors. The annual “doc fix” has meant continued uncertainly and instability for seniors and their families, physicians and our nation’s economy. This is unacceptable.
In March, I reintroduced the bipartisan Medicare Physician Payment Innovation Act (H.R. 574) with Rep. Joe Heck, DO (R-Nev.). This legislation fully repeals the sustainable growth rate (SGR), the flawed formula that dictates payments to Medicare providers. It also implements new delivery systems and payment reforms to ensure long-term stability in the Medicare physician payment system, while containing the rising growth in health care costs. To date, the bill has been endorsed by more than 30 national organizations representing a wide range of providers, seniors and consumers.
Today, the effort for a permanent “doc fix” took an important step forward when the House Energy and Commerce Committee advanced its own bipartisan SGR repeal legislation. The committee’s proposal, President Obama’s budget and my legislation all reflect a bipartisan agreement on a common overarching framework for permanent physician payment reform. I commend Energy and Commerce Chairman Fred Upton (R-Mich.), Ranking Member Henry A. Waxman (D-Calif.) and the committee’s members for their important work on this issue.
We have an opportunity to improve this legislation as the process moves forward so that it not only requires more reporting and accountability, but also transforms our system to reward quality and value. This means shifting public dollars to more integrated and team-based models so that we can ensure access to necessary, patient centered care for all seniors.
We can and should challenge more health care providers to move away from our fragmented fee-for-service payment system to more coordinated, higher-quality, lower-cost care for seniors. Nationwide, tens of thousands of physicians are transforming their practices, whether through the patient-centered medical home, accountable care organizations, bundled payments or other new and innovative models.
These innovations are rapidly becoming the norm in the private sector and it is time that Congress recognizes their potential. My legislation acknowledges that some physicians face barriers to exiting the current system and maintains an exemption for physicians participating in a modified fee-for-service option. But, with the right options and resources, the vast majority of physicians in this country can participate in new models of care that work for their practices and patients.
We must embrace this opportunity to move the physician payment system from volume-driven fee-for-service to a system that rewards quality, care coordination, improved outcomes and efficiency. The Energy and Commerce Committee’s effort is a vital step in the process. I am committed to working with my Republican and Democratic colleagues on the Ways and Means Committee, as well as members of Energy and Commerce and Senate Finance, to make our shared goals a reality. There is no excuse for further inaction.
Schwartz has represented Pennsylvania's 13th Congressional District in the House of Representatives since 2005. She sits on the Budget and the Ways and Means committees.