Unsustainable?

From Medscape Internal Medicine

Solving the “Unsustainable” Physician-Pay Problem: Perspectives From the ACP, ACS, and ACC

Robert L. Lowes

Much of organized medicine applauds a healthcare reform bill in Congress that defuses a Medicare time bomb next year — namely, an overall 21.5% pay cut.

But can that legislation defuse an even bigger time bomb: the growth in Medicare and Medicaid spending that threatens to put the federal budget “on an unsustainable path,” according to the Congressional Budget Office (CBO)?

The bill’s provisions to scrap the Sustainable Growth Rate (SGR) formula in Medicare that triggered the pay cut would seem to expand the federal deficit, not shrink it. However, the bill also funds experiments to pay physicians on the basis of quality and cost-effectiveness and to wean them from the more expensive fee-for-service model, which motivates physicians to pump up the volume of services rendered. In the words of the Medicare Payment Advisory Commission (MEDPAC), this piecemeal approach “has created a rate of volume growth that is unsustainable.”

Supporters of the legislation acknowledge the need to pull the plug on the traditional fee-for-service model. “We believe in moving to a model that gives doctors a financial incentive to provide good care — it’s quality, not quantity,” said internist Joseph Stubbs, MD, of Albany, Georgia., president of the American College of Physicians (ACP) and one of several leaders in organized medicine that Medscape Medical News interviewed on healthcare reform and physician compensation.

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Read More at Medscape….