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Posted by on Jul 8, 2010 in Health care

Expert: Congress Won’t Repeal SGR Formula

Expert: Congress Won’t Repeal SGR Formula


When it comes enforcing or repealing the SGR formula, the legal fix that was designed to reduce Medicare growth way back in 1998, don’t look for decisive action from Congress any time soon. So says Henry Aaron of the Brookings Institute* in this week’s NEJM

Congressional enforcement of the SGR formula is untenable because it means making increasingly draconian cuts in physician reimbursement (~21% this year). But the abomination (as Aaron calls it) won’t be repealed because the Congressional Budget Office will view the act as an increase in spending. So for now, Congress repeatedly suspends the formula, while keeping the law “on the books” to avoid a monstrous increase in the already monstrous deficit.

However, Aaron offers hopealbeit faint hope. The Patient Protection and Affordable Care Act (aka ObamaCare) offers several provisions that allow for the study of pilot programs (eg, accountable-care organizations) that may [yeeshtugging at neckline] streamline healthcare and cut costs. Physicians could someday be sufficiently motivated to participate in one or more of these programs, Aaron argues, if the alternative is sustaining a very-deep SGR-defined gash in Medicare reimbursement. Aaron evokes the near-future image of Congress as Vito Corleone (“make physicians offers they can’t refuse), but I’ve got a more vivid picture: Luca Brasi and the Johnny Fontane contract.

SGR = sustainable growth formula.

* Not Henry Aaron of the MLB.

Photo of weathered can from magannie at Flickr.

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.