MedPAC prepares 'doc fix' proposal with full cost offset

The plan takes the commission into an area it generally tries to avoid: how to pay for such a major change to the Medicare system. Its suggestion is to pay for the SGR fix by reducing payments to specialists and imposing cuts on other parts of the health care sector.

CQ HealthBeat: Hackbarth Floats $200 Billion Physician Payment Overhaul With 'Full' Offsets
In a statement that could heighten doubts about the ultimate success of the health care law, Medicare Payment Advisory Commission Chairman Glenn Hackbarth said Thursday that using planned Medicare savings to cover the uninsured and cut the deficit -; and not addressing the "sustainable growth rate" (SGR) physician payment formula -; could destabilize the program. Hackbarth said that at its October meeting, the advisory panel will vote on a set of recommendations to replace the SGR formula at a cost of about $200 billion over 10 years. Scrapping the formula would end the current system of physician reimbursement that tries to recoup physician outlays that exceed certain yearly spending targets by making ever-larger payment cuts (Reichard, 9/15).

Politico Pro: MedPAC Takes Risk With 'Doc Fix' Proposals
MedPAC's proposal to pay for avoiding a 30 percent cut to physician payments in 2012 has taken it into territory the commission usually avoids: how to pay for making such a big change to the Medicare system. … A MedPAC staff member declined to answer a question on the record about the extent to which Congress solicited input on how to pay for a fix to the Sustainable Growth Rate formula. MedPAC's proposal to pay for the SGR fix by cutting payments to specialists and taking big bites out of other health care sectors is, not surprisingly, widely disliked by the industry. The MedPAC plan proposes widely distributing the $300-plus billion dollar cost of eliminating the existing SGR formula among the industry and beneficiaries. This has obvious political perils (Feder, 9/16).

Kaiser Health News: Capsules: MedPAC Preparing Doc Fix Plan – With Offsets
Even before MedPAC finalizes a long-term doc fix proposal, the complicated – and expensive – task is proving difficult. The Medicare Payment Advisory Commission, which advises Congress on Medicare payment policy, is drafting a plan to permanently replace the program's current method for paying physicians. It intends to get a proposal to Capitol Hill in October, but today's draft already is sparking controversy (Werber Serafini, 9/15).