Reports and Resources

By
PFM
05/06/2015

The Medicare Sustainable Growth Rate (SGR) is the formula currently used by the Centers for Medicare and Medicaid Services (CMS) to determine the appropriate fee schedule for payment to physicians that will keep costs to the program in line with Gross Domestic Product (GDP). The SGR was enacted as part of the Balanced Budget Act of 1997 as a means to control rising Medicare costs. The formula uses four factors to determine the SGR: changes in physicians’ service fees, percentage change in the number of Medicare beneficiaries, the 10-year average annual percentage change in GDP per capita, and any changes in the Medicare budget due to legislation.

By
PFM
12/22/2014

The 1603-page cromnibus is a combination of a continuing resolution (CR) and an omnibus spending bill, hence its unique name. An omnibus typically combines a number of smaller appropriations bills into one large bill, whereas CRs are usually used to keep the government running for short periods of time while more permanent budget discussions are occurring. The current cromnibus funds most of the government through September 2015, though the CR portion funds the Department of Homeland Security through February 2015.

By
PFM
08/06/2014

On July 15, 2014, the Congressional Budget Office (CBO) released its long-term budget outlook.[i] Under the assumption that relevant laws remain the same, this annual report projects 10 years and 25 years of future federal spending and revenues, including for the nation’s major health insurance programs – Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Importantly, the report is not a prediction of spending in the future, but rather a demonstration of the effects current policies will have on the economy over time if left unchanged.

By
PFM
07/18/2014

As a federal agency with distinct regulatory and rule-making authority, the Centers for Medicare and Medicaid Services (CMS) issues many proposed rules and regulations each year that impact the programs it administers. These rules vary in scope and typically impact a set of limited, specific issues.

The proposed rule released in early July each year is particularly vast and impactful because it makes sweeping changes to payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS).

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