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SGR: Include Fee Schedule Overhaul in Fix, Experts Urge
HealthLeaders Media

Any legislation to reform the sustainable growth rate formula for physician payment under Medicare should also include an overhaul of the physician fee schedule, according to several experts.

“Fixing inaccurate valuations in the Medicare fee schedule will be vitally important to the success of the … SGR fix,” wrote James Reschovsky, PhD, Larisa Converse, MA, and Eugene Rich, MD, all of Mathematica Policy Research, a Washington consulting firm. “Inaccurate valuations would make it easier for some physicians, particularly specialists, to maintain incomes in the fee-for-service pathway by shifting the mix of services they provide to favor high-profit procedures, despite low fee updates.” Their article appears online and in the April 2015 issue of Health Affairs.