Reports and Resources

By: 
PFM

Bi-partisan agreement exists to move away from Medicare’s fee-for-service (FFS) model. Repealing the SGR formula will be an important step in this transition. PFM has created a side-by-side comparison of four proposals to repeal Medicare’s SGR formula and institute new payment and delivery models:

  • The Medicare Physician Payment Innovation Act of 2013 (H.R. 574), sponsored by Representatives Allyson Schwartz (D-PA) and Joe Heck (R-NV), stabilizes current payment rates in the near-term, eliminates scheduled SGR cuts, creates incentives for undervalued primary, preventive and coordinated care services and sets out a path toward payment reform.
  • The Medicare Patient Access and Quality Improvement Act of 2013 (H.R. 2810), sponsored by Representatives Michael Burgess (R-TX), Frank Pallone (D-NJ), Fred Upton (R-MI), Henry Waxman (D-CA), and John Dingell (D-MI), establishes measures of care and allows providers to participate in reform efforts.
  • Moving Forward from the Sustainable Growth Rate, first introduced by the Medicare Payment Advisory Commission (MedPAC) in 2011, recommends replacing the SGR with 10 years of specified updates to the fee schedule, with special consideration for primary care services.
  • PFM’s Policy Recommendations focus on the transition period for moving away from FFS to more innovative models, calling for FFS to be phased out in five to seven years.

Read the full comparison here.

Date: 
Monday, July 15, 2013