Dear Leader Reid, Leader McConnell, Speaker Boehner, Leader Cantor, Leader
Pelosi, and Whip Hoyer:
On behalf of the Alliance of Specialty Medicine (the Alliance), a coalition of medical
specialty societies representing more than 100,000 physicians and surgeons, we are
writing to strongly urge Congress to enact a permanent and meaningful solution to
the flawed Sustainable Growth Rate (SGR) formula. An SGR replacement should base
physician reimbursements on the actual cost of providing care and allow physicians
to make investments in meaningful and relevant care delivery models that aim to
improve quality and efficiency and foster patient access to the physician of their
choice.
While we are encouraged that the process to repeal the SGR is moving through
Congress, not a single proposal fully captures the principles that the Alliance
believes are critical to physician payment reform. These include:
- Positive updates: Repeal of the SGR must include a minimum 5-year period
of stability during which base payments to physicians capture the true cost of
treating patients. This should include positive financial incentives for higher
quality, more efficient care rather than arbitrary penalties and withholds. - Recognition of multiple payment and delivery models, including fee-
for service (FFS): Physicians must be given the opportunity to participate in a
range of delivery and payment models that are meaningful to their practices
and patient populations, including FFS. - Physician-led quality improvement: The medical profession and its clinical
subject matter experts must determine the most appropriate and clinically
relevant quality improvement strategies for their practice types and patient
populations. - Reward personal improvement: A reformed payment system must not
create a zero-sum game of “winners” and “losers” based on arbitrary
performance benchmarks that pit physicians against each other, but instead
incentivize personal growth. - Legal protections for adherence to clinical guidelines and quality
improvement program requirements: New standards of care created by
quality improvement programs must not be used in medical liability suits. - Repeal of the Independent Payment Advisory Board (IPAB). Significant
health care decisions must not be made by a group of unelected,
unaccountable individuals with little or no clinical expertise or the oversight
required to protect access to care for America’s seniors. - Private Contracting: Physician payment reform must allow for voluntary
private contracting between physicians and Medicare beneficiaries. - Appropriate public reporting: While patients deserve tools for informed
medical decision-making, publicly reported data must not be expanded
without first ensuring such data are truly indicative of physician quality and
meaningful to consumers.
The Alliance looks forward to working with Congress to refine SGR legislation and
working with you find a permanent and meaningful solution to the flawed physician
payment system. We would be happy to discuss our concerns with you or answer
any other questions, and can be reached at info@specialtydocs.org.
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