David B. Hoyt, MD, FACS, Executive Director of the American College of Surgeons (ACS), and representatives of other physicians’ organizations provided testimony, which can be viewed at http://www.facs.org/ahp/medicare/hoyt.513.html during a May 7 House Ways and Means Subcommittee on Health hearing. The hearing centered on a joint proposal that the House Ways and Means and Energy and Commerce Committees have developed to reform the Medicare physician payment system. There is widespread agreement in Congress that repealing the sustainable growth rate (SGR) formula is a necessary first step toward reforming the current system.
"We need to repeal the SGR so that seniors continue to have access to their local doctors," Rep. Kevin Brady (R-TX), chair of the subcommittee, said in his opening remarks. "In our communities, we are witnessing first-hand how the current broken system is forcing doctors to rethink their future with Medicare, consider closing their private practices or joining up with a hospital. The SGR is a major contributor to an unhealthy system—and it needs to change this year."
The College expressed appreciation for the committees’ acknowledgment that the current Medicare physician payment system and the SGR are fundamentally flawed and for the joint proposal’s elimination of the SGR during the first phase of implementation. The College also supported efforts to find more innovative models of physician payment and asserted that any new payment system should be based on the complementary objectives of improving outcomes, quality, safety, and efficiency while reducing the growth in health care spending. The College offered its Value Based Update (VBU), proposal which can be viewed at http://www.facs.org/ahp/news/2013/may.html, as a way to accomplish these goals. Dr. Hoyt answered several questions regarding the VBU and the College’s work on quality measurement, including the use of national registries and databases to compile data and facilitate the exchange of information among health care providers. More information on the College’s perspective on the joint proposal can be found in the February response letter, available at http://www.facs.org/ahp/medicare/response-ec-wm.2.13.pdf, and the April response, which can be viewed at http://www.facs.org/ahp/medicare/response-ec-wm.4.13.pdf.