乌鸦传媒

NATIONAL HARBOR, Md. -- Not surprisingly the American Medical Association is not a fan of Congress' proposal to freeze Medicare payments to physicians for a decade formula.

Medicare reimbursement, the AMA argues, has consistently been well below the cost of providing care, thus a freeze would unduly burden already-cash-strapped medical practices, , told 乌鸦传媒.

Hoven sat down for a one-on-one interview shortly after the adjourned Tuesday morning.

乌鸦传媒: What was your reaction when you found out Congress proposed to freeze Medicare payments for 10 years as part of an SGR repeal?

Hoven: Remember the AMA has been advocating for months and months now that -- not only do we repeal the SGR once and for all -- we would provide stabilization of payments and updates adequate to allow physicians to then move into innovative models of care. And that requires infrastructure and that infrastructure requires money.

So I think like most doctors when you looked at that draft initially, the reaction was: 'oh, my goodness, this is terrible.'

We can't have this.

But then when you sit down and you start thinking about and looking at this in more detail, it's a draft. We know what we need to do. We need to pursue this because at the end of the day continuing with an unsustainable payment formula, the SGR, is not in the best interest of medicine or healthcare.

MPT: Given the pressures on Congress to rein in healthcare costs, are you confident the AMA's concerns about the 10-year pay freeze can be addressed before an SGR repeal becomes a law?

Hoven: We understand the fiscal issues very clearly, and we understand there are going to have to be offsets and "pay-fors." This is something Congress is going to clearly have to deal with. But at the end of the day, to ask physicians to sustain a freeze for another 10 years on top of what they have already sustained, when the cost of care continues to rise, when our costs are up 20%, is not reasonable either. You have to balance the two.

Members of Congress hear this. They understand this. and updates. They get it. They're having to struggle within the confines of the fiscal barriers that they have as well. But there are ways that this can be done. There are ways that they can manage this. This is their job.

MPT: Where you surprised with the level of support your resolution in support of an SGR repeal received even with a 10-year pay freeze on the table?

Hoven: It's always good as we begin to have these discussions and debates and dialogues that we get everybody's views heard. I think we were able to do that at this meeting.

What I saw and what was very good and pleased me greatly was the way the delegates representing diverse groups walked across the aisle and said let's work on this, let's collaborate, and came out at the end with something that everyone was good with, could support aggressively.

MPT: What options are there for paying for the SGR repeal?

Hoven: I don't think we really know. I think there are multiple opportunities that need to be looked at. We don't know right now what those are going to be. At the end of the day, what we want to be sure of is that the patients get what they need, and that they continue to get the healthcare they need, but that the physician practice can be stabilized.

MPT: Medicare payments to doctors are set to be cut by roughly 24% starting Jan. 1 when the SGR's cuts go into effect. Congress has yet to release formal legislative language, but could markup a bill as early as next month. How do you balance staving off potential SGR pay cuts with the need to finalize the repeal legislation -- is the AMA in danger of putting the cart before the horse?

Hoven: Congress is very, acutely aware of what their timelines are and are very aggressively working on this. They're out there pushing this and getting this done. They want this taken care of. They want this off their plate. They don't want to have to deal with this anymore.

I think they've got the wherewithal to do it. I think they're energized to do it. We have to be sure that we, the medical community, are making ourselves available to them in any way possible to help them facilitate this.

MPT: Other concerns with the draft SGR repeal bill?

Hoven: If you look at the Value-Based Purchasing program that's talked about a great deal. What we've got to be sure is that the risk is narrowed and that the cuts are narrowed. Because, again, this could be damaging.

At the end of the day, what you want are programs that the measures, for example, have been written by doctors for doctors. If you look at our , that's in fact what we talk about.

Then you want incentives that are equitable for physicians so that they can get paid for doing this work. Physicians understand the innovation around delivery, and about quality, and about safety. They've been at the center of this many, many years. We want to make sure this legislation gets that right. And a lot of the discussion, a lot of the points that we're going to make to Congress and we have been making to Congress have got to do with that.

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