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ASA Offers Recommendations on Most Recent SGR Repeal and Replace Proposal

Tuesday, November 12, 2013

On November 12, the American Society of Anesthesiologists (ASA) responded to the Senate Finance Committee and House Ways and Means Committees' recently released joint bipartisan and bicameral framework for repealing and replacing the Medicare Sustainable Growth Rate (SGR) formula.  ASA applauded efforts to repeal the flawed SGR and offered a series of recommendations in response to the Committees' request for stakeholder feedback on the initial framework.

ASA highlighted the specialty's unique 33 percent payment problem and noted that this problem would be compounded by a 10 year freeze in physician payments.  ASA instead suggested "the addition of an inflation adjustment to the 10 year freeze as a mechanism to ensure that the value of payment remains constant." 

The Committees' proposal suggests unifying quality-based payment programs into one cost-neutral Value Based Performance Payment Program.  ASA expressed concern about the technical parameters of such a program noting previous specialty-based compliance issues, the method of weighting measures, and the potential for insufficient weighting of clinical practice improvement activities.  ASA offered a possible resolution through specialty-specific weighting.  ASA was also encouraged that the Committees would allow funds for misvalued codes to be redistributed in the physician payment pool.

ASA noted that Advanced Payment Models (APMs) "are an important component of the future of our health care system."  ASA highlighted that the society "is heavily invested and engaged in ongoing work to develop its own innovative model of care—the Perioperative Surgical Home."  

Earlier this year, the House Energy and Commerce Committee's proposal to repeal and replace the SGR, H.R. 2810, the Medicare Patient Access and Quality Improve Act of 2013 passed the Committee by a vote of 51-0.

ASA will continue to closely monitor all legislative efforts to repeal and replace the SGR.

Review ASA's recommendations. 
Review the Committees' Joint Press Release.
Review the Committees' Framework Document.
Review the Committees' FAQ.
Review the Committees' Overview of Current Law Physician Reporting/Incentive Systems.
Information about H.R. 2810, Medicare Patient Access and Quality Improvement Act of 2013. 

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