Despite strong objections from ASA and numerous other physician provider groups, on October 6, 2011, the Medicare Payment Advisory Commission (MedPAC), the commission tasked with advising Congress on Medicare payment issues, formally recommended a plan that would help cover the costs of Medicare Sustainable Growth Rate (SGR) repeal by cutting payments to specialty physicians, such as anesthesiologists, by nearly 18 percent over three years. The recommendation is part of a broader plan to replace the flawed Sustainable Growth Rate (SGR) formula with a 10-year budget-neutral payment plan that differentiates specialty physicians from primary care physicians.

For specialty physicians, the recommendation would reduce payments 5.9 percent annually in years 2012, 2013 and 2014, followed by payment freezes for the final seven years. Payments for primary care specialties would be exempt from the payment reductions and would instead be frozen at current 2011 levels for the entirety of the 10-year period. 

ASA urged MedPAC not to formally recommend the proposed plan. In a formal communication to MedPAC, ASA President Mark A. Warner, M.D., stated, “While we support permanently fixing the SGR, we believe cutting payment for anesthesia by 5.9 percent each year over the next three years, followed by a freeze in payment would harm patient access to care and does not take into account that Medicare currently pays anesthesiologists only 33 percent of the average commercial insurance payment for the same service.” 

The future of these recommendations is unclear. While legislators are under no obligation to implement any of MedPAC’s recommendations, it is possible that the recommendations could become part of larger Medicare payment discussions. ASA will continue to lobby decision-makers against MedPAC’s plan to cut specialty physicians to protect primary care physicians. 

Read the letter ASA President Mark A. Warner, M.D., sent to MedPAC opposing the recommendations.