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Protect Seniors' Access to Doctors

Today, 39 million seniors depend on Medicare to ensure that they have access to doctors they can count on to help them make the best decisions for themselves and their families.  Unfortunately, seniors’ access to doctors is in jeopardy because Congress has failed to reform a flawed physician payment system that is scheduled to slash rates by 21 percent on June 1, 2010.

That’s why AARP is calling on Congress to pass HR 4213, legislation that will provide doctors who treat Medicare patients with stable pay and give seniors the security and peace of mind they deserve.  HR 4213 would prevent the 21% rate cut and provide doctors with a steady reimbursement rate they can count on until 2014.

For nearly a decade, Congress has used short-term patches to prevent imminent cuts to the physician payment formula – a short-sighted approach that has undermined the trusted doctor-patient relationship. Maintaining such an unstable funding system will inevitably mean more and more doctors – especially primary care doctors – will refuse to see Medicare patients.  According to a recent study by an independent agency (MedPAC) that advises Congress on Medicare, nearly 22 percent of beneficiaries who were looking for a new primary care physician reported problems finding one.

AARP believes it is time for the government to honor its commitment to Medicare patients and to the physicians who care for them by ending this cycle of stop-gap measures that push common-sense solutions ever farther out of reach. 

AARP is urging Congress to support HR 4213 – a common-sense approach to guarantee that seniors who’ve worked their whole lives to earn the right to Medicare will have access to doctors who will treat them. 

Common Sense Solution

HR 4213 would improve payments to doctors who treat Medicare patients and protect seniors’ access to doctors by:

Preventing the drastic 21% cut in physician payments.

  • Providing a 1.3% update effective June 1, 2010, and an additional 1% update on January 1, 2011.
  • Guaranteeing doctors an update of no less than zero percent from 2012 until 2014; primary care physicians will receive higher updates than specialty care, and physicians who choose to participate in Accountable Care Organizations (ACOs) may choose to establish ACO-specific targets to encourage delivery system reform.

Background

  • Medicare pays doctors according to what is known as the “sustainable growth rate formula” or SGR.  This system was originally designed to cap how much Medicare pays doctors.  However, since 2002, what Medicare has actually spent on physician services has exceeded the SGR cap, so physician payment rates have been slated for dramatic reductions. 
  • But, instead of reforming this flawed payment system, Congress has relied on temporary band-aids that have undermined seniors’ health security and have driven up what it will cost to provide doctors with stable pay.

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