Senate Finance Committee Holds Third Roundtable on Medicare Payments

TheSenate Finance Committee held its third roundtable discussion on Medicare physician pyaments, July 11,  producing the most dialogue between committee members and panelists of the three roundtables.

Panelists focused  prepared comments on incentivizing quality, new payment structures, and the availability of data. Participants advocated for more  funding to develop quality measures, and explained the important role of clinical registries in improving outcomes.
Panelists also stressed the need for new payment structures that incentivize care coordination and the patient-centered medical home. They said geographic and practice differentials must also be implemented since a single payment model is not sufficient.  They added that multiple models and blended payment models are needed rather than a "one size fits all" or another sustainable growth rate (SGR) approach. Two of the panelists emphasized the importance of physician access to relevant and timely data.

Discussion resulted in  broad agreement that physicians must be involved in developing new payment models and determining where value can be found in the system.  Medical liability reform, geoprahic disparities in payment, and the interoperatability of EHRs  were also identified as having a negative impact on costs. 

Chairman Baucus (D-MT) and Ranking Member Hatch (R-UT) concluded the hearing by asking the panel for suggestions of what can be done now to fix this problem. Responses included:
  • Replace the SGR with value-based updates
  • Provide positive updates
  • Stabilize the payment system
  • Promote and test a variety of payment models through CMMI that physician practices can choose between and enter on a rolling basis rather than only during a brief window
  • Consider the "Medicare Physician Payment Innovation Act" (HR 5707) as introduced by Reps. Allyson Schwartz and Joe Heck, DO as a model.