The Medicare physician payment un-Sustainable Growth Rate formula (SGR, or SGRrrr expressed as a growl) is once again heading for a train wreck of 29.5% Medicare cuts for all physicians on Jan. 1, 2012, unless Congress once again acts in their budget discussions to postpone the next chapter of this seemingly endless doomsday timetable. To his credit, President Obama requested in his budget an additional two-year moratorium on SGR cuts to extend through January of 2014, but the cut-crazy Congress isn’t crazy about the $55 billion price tag for this SGR-cut extension it seems.

BTW, imagine if leaders of Congress were even more progressive in their thinking and were willing to fund less than 1% of that cost -- only around $500 million (budget dust) -- which could create an interoperable NCDR-like registry system across all specialties to systematically reduce costs by improving quality of care. Ironically, at last week’s meeting in DC of the Physicians Consortium for Performance Improvement (PCPI), the quality measure and QI consortium convened by the AMA, ACC attendees participated in a discussion with many other specialties in which we suggested just that. We did so after seeing a terrific presentation underscoring the advantages of such a system that is up and running and funded by the government in Sweden. It’s fantastic. 

But I digress. Back to the SGRrrr.  The Trustees of the American Medical Association and other medical societies have warned that such a huge pay cut would force physicians to turn away not only seniors but also military families whose TRICARE coverage is based on Medicare rates.

We all signed an AMA-created letter to House and Senate leaders last week outlining the problems mounting as the SGR threat looms once again. The letter asks Congress to replace the SGR formula.  Of course that would cost about $380 billion, so I’m not holding my breath on that one, welcome as it would be. After all, Congress has been postponing SGR-required cuts every year since 2003, causing them to balloon in size in successive years. It’s a national tradition now.

Last December, the previous (lame duck) Congress spared doctors a 25% cut which would have hit January 1, 2011, by postponing it for 1 year. This Congress seems kinda frozen at the moment, on this and all issues.

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