OPINIONRays of hope needed in Medicare muddleAMA Leader Commentary. By Duane M. Cady, MD, Feb. 6, 2006. A message to all physicians from the chair of the AMA Board of Trustees, Duane M. Cady, MD. Amid the confusion and anxiety over the physician payment cuts mandated by Medicare's fatally flawed sustainable growth rate, one ray of hope emerged that has real potential for the future. Don't get me wrong. The jury is still out, as of this writing, and I cannot say with certainty that the draconian 4.4% cut in the sustainable growth rate will be rejected and the federal government will continue in 2006 to use the 2005 rate. To paraphrase Winston Churchill, though, I believe we may not be at the beginning of the end to our sustainable growth rate problems, but we are at the end of the beginning. By that I mean real progress has been made, clear dialogue has begun and a pattern of action is emerging from the haze of skirmishes. This is especially true in the area of federally imposed quality standards at the heart of the pay-for-performance issue. As you might know, the Dept. of Health and Human Services' Centers for Medicare & Medicaid Services had proposed implementing a form of pay-for-performance -- the Physician Voluntary Reporting Program -- as a precursor to a full-blown pay-for-performance program. In our discussions with CMS Administrator Mark McClellan, MD, PhD, we were able to convince him to modify his program, to allow us and others to offer alternative ideas. Rep. William Thomas (R, Calif.), chair of the House Ways and Means Committee, made it crystal clear to me in December 2005, when we discussed the SGR matter, that Congress and CMS want very much to include a pay-for-performance mechanism with future Medicare reimbursement plans. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2006 American Medical Association. All rights reserved.
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