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May 2015
CLINICAL PRACTICE MANAGEMENT
Sustained Advocacy Yields Win on Medicare Reimbursements

Following many years of advocacy by medical societies, including IDSA, Congress approved and President Obama signed legislation to promote seniors’ access to high-quality healthcare by repealing the Medicare Sustainable Growth Rate (SGR), a mechanism established in 1997 to control Medicare costs in part by cutting physician reimbursements. In the last year, IDSA members sent nearly one thousand messages to Capitol Hill urging repeal of the SGR. This outreach, combined with similar efforts by members of partner organizations, can be credited with pressuring Congress to act. Since the establishment of SGR, Congress has passed 17 temporary patches to prevent significant cuts to reimbursements.  

The Medicare Access and CHIP Reauthorization Act permanently replaces the SGR with a program that emphasizes quality while containing costs and providing increased certainty for patients and providers. Beyond repealing the SGR, the new law consolidates the three existing quality reporting programs into one merit-based incentive payment system. Medicare providers will be given a five-year period of 0.5 percent updates to transition to the new system. Physicians who participate in alternative payment models and meet certain thresholds will be eligible for incentive payments. Participation in alternative payment models is voluntary, as the new law retains the Medicare fee-for-service model.

In the months ahead, IDSA will work with Congress and the Center for Medicare and Medicaid Services to encourage proper implementation of the law and address issues of particular importance to the ID specialty. An analysis of the legislation is available on the House Energy & Commerce Committee website.



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