Will Congress's Latest "SGR Fix" Control Medicare Costs?

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Congress is considering legislation that would replace Medicare’s current payment formula for physicians with one that rewards the delivery of “high value” care. But according to a new Commonwealth Fund–supported analysis in <em>Health Affairs</em>, the proposal’s shortcomings will need to be addressed for the new payment method to succeed.<br /><br />
Medicare’s current “sustainable growth rate formula,” or SGR, does little to discourage providers from ordering high-cost services for their patients instead of cheaper, equally effective treatments. But while the new approach creates incentives for specialists to participate in pay-for-performance and other alternative payment programs, it continues to undervalue preventive care and other relatively low-cost services, say analysts at Mathematica Policy Research. <br />
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While James D. Reschovsky and coauthors acknowledge that “correcting fee schedule valuations will be a substantial and controversial undertaking,” they argue “it is one that is vitally important to the SGR fix’s prospects for success.”<br />

http://www.commonwealthfund.org/publications/newsletters/ealerts/2015/mar/will-congresss-latest-sgr-fix-control-medicare-costs Read the study