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AAFP: Disappointed but not surprised by SGR deal


Disappointed but not surprised was the reaction of the American Academy of Family Physicians’ (AAFP) president after Congress passed legislation last week that saved Medicare payments from a drastic cut but didn’t solve what he considers to be the underlying problem. The group continues to work toward a repeal of the sustainable growth formula (SGR).

“If there’s any consolation, at least [Congress] didn’t wait until the very last second,” AAFP’s Glen Stream, MD, tells Medical Economics eConsult.

February 17, Congress passed legislation to extend a payroll tax cut for employers and included a provision for a 10-month patch to the current Medicare physician payment rates. The measure avoided a 27.4% payment cut dictated by the SGR, a 15-year-old formula designed to keep physician payments even with changes in the gross domestic product. For nearly a decade, Congress has stepped in to head off payment cuts.

Before the most recent patch, doctors’ groups proposed that Congress use military funds earmarked for the wars in Iraq and Afghanistan, called Overseas Contingency Operations (OCO) funds, to repeal the SGR permanently. The OCO funds plan was encouraging, Stream says.

“It seemed like a reasonable means to accomplish a permanent fix,” he says. “We had supportive comments from both chambers of Congress and from both parties about using the OCO funds as a means to offset the accrued debt attributed to the SGR, so we could at least start from scratch with a level playing field.”

Stream says the AAFP leadership will meet in the next few weeks to discuss its political advocacy strategy for continuing to push for the SGR repeal.

“What we don’t want is for [Congress] to wait until December and have this cliff occurring once again,” Stream says. “The idea is to utilize these 10 months to find, not just another short-term fix, but a long-term solution.”

As Congress agreed on the patch, four doctors’ groups—the American College of Physicians, the American College of Surgeons, the American Osteopathic Association and the AAFP—which collectively represent 500,000 doctors, issued a joint statement admonishing lawmakers for the temporary fix.

“We are especially frustrated because Congress has had a short-lived window of opportunity to eliminate the Medicare [SGR] formula, once and for all, using unspent monies for overseas military operations,” reads the statement. “Congress must do its part and enact permanent repeal of the SGR—before 2012 comes to a close.”

After this 10-month extension expires, doctors face a 32% Medicare payment cut on January 1, 2013, unless Congress intervenes.

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