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Is a Medicare 'Doc Fix' in the Works?

Two bipartisan proposals aim to stabilize Medicare pay for doctors

medicare fix doctor leaning on wall hospital pay cuts payment coverage harder


Stabilizing Medicare pay for doctors is an issue that has plagued lawmakers for a long time.

In an era when cooperation in Washington can seem impossible, two bipartisan proposals now circulating aim to resolve a problem that has plagued lawmakers a long time — how to stabilize Medicare pay for doctors.

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Each year the current payment system (called the sustainable growth rate, or SGR, which tethers doctors' pay to overall growth in the economy) leaves doctors worried about a major pay cut, leaves older adults worried that their doctors will exit the program, and leaves lawmakers scrambling for funds to ease everybody's minds — but only for one more year.

The bipartisan proposals would get rid of the SGR, which also, experts say, increases Medicare costs by rewarding physicians who provide more tests, procedures and office visits. The proposals would level doctor payments and base future increases for individual physicians on better and more effective and efficient care.

One proposal, a bill introduced by Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.), would offer modest pay raises for four years before basing increases on quality and efficiency of care. The other bill, backed by members of the House Ways & Means and Energy & Commerce committees, would establish a period of predictable, defined payment rates to doctors before similarly offering incentives for better service.

Neither bill details where an estimated $138 billion of needed funds would come from. There's "plenty of room for agreement if people want to find it," Rep. Jim McDermott (D-Wash.) said recently.

Ariel Gonzalez, director of the AARP federal health and family team, says older adults have tired of "Doc Fix" deadlines. "We would like to see a formula that emphasizes primary care and ensures access to physicians and other providers," he says. "We are willing and open to any and all legislative proposals that deal with repealing and replacing the SGR."

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