Bush eyes EMRs, P4P to slow Medicare spending

The president's bill also calls for medical liability reform and more cost sharing by Part D enrollees.

By Doug Trapp, AMNews staff. March 3, 2008.

Washington -- President Bush's legislation to slow Medicare spending is heavy on provisions related to doctors -- from public quality rankings of physicians in five years to instituting pay-for-performance. But the bill doesn't address Medicare physician pay cuts due to take effect July 1.

James King, MD, president of the American Academy of Family Physicians, said Medicare pay reform needs to be a higher priority for the administration. "They have to come to terms with how they're going to pay physicians, where the money is going to come from and [how to] pay toward what they want to accomplish." The American Medical Association is working to prevent the 10.6% pay cut scheduled to kick in for the last six months of 2008.

Bush was required by the Medicare Modernization Act of 2003 to offer a proposal to rein in program spending. The act mandates that the president submit a Medicare reform plan if, for two consecutive years, 45% of the program's funding was projected to come from general tax revenues instead of dedicated payroll taxes or premiums within six years. The Medicare trustees projected in 2006 and 2007 that this would happen.

"This legislative package ... would take the first step of responding to the funding warning in the trustees' 2007 report," wrote Health and Human Services Secretary Mike Leavitt in a letter to House and Senate leaders. "Perhaps more importantly, it would begin to address the long-term challenge and lay the foundation for the comprehensive Medicare reforms that are necessary to strengthen and improve the program for future generations."