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AMA to the Chicago Tribune: Medical costs

Aug. 1, 2013 (published)

The Chicago Tribune
Letter to the Editor

To the Editor:

The Chicago Tribune did a remarkable disservice to readers by publishing a flawed article on an American Medical Association committee's role in providing expert recommendations to the Centers for Medicare and Medicaid Services ("Doctors' pay valuations debated; AMA data on procedure times would have some on job more than 24 hours a day," Business, July 26).

In recent years, the committee has taken the initiative to identify overvalued medical services to help drive cost reduction. To date, they reviewed about 1,300 potentially misvalued services and recommended reductions to 500 previously overvalued services, redistributing $2.5 billion to primary care and other services. The committee is currently reviewing gastrointestinal services, including colonoscopy procedures. That review will be complete next year.

But let's not forget that the Medicare physician payment system is ultimately budget-neutral. There is no financial impact if the government accepts a recommendation for increasing a medical service value because any increase is automatically offset by decreasing values assigned to all other services. It also should be noted that the annual growth in Medicare physician services has been at a historical low for each of the last three years — less than 1 percent.

We ensured transparency of the process, making the data and rationale for each committee recommendation publicly available, and representatives from the Centers for Medicare and Medicaid Services attend all committee meetings. And while the committee submits recommendations to CMS for consideration each year, the agency is not obligated to accept them. The general public is also able to comment on individual procedures, and processes are in place to ensure that input from all stakeholders is considered by CMS.

Medicare provides health care coverage for millions Americans; it's unfortunate the article chose to play fast and loose with facts.

Ardis D. Hoven, MD
President, American Medical Association