ASA Urges MedPAC to Reject SGR Draft Plans to Cut 18%
On October 5 and 6, 2011, the Medicare Payment Advisory Commission (MedPAC), the commission tasked with advising Congress on Medicare payment issues, will meet to review a draft recommendation that would help cover the costs of SGR repeal by cutting payments to specialty physicians, such as anesthesiologists, by nearly 18 percent over three years.
In a letter written to MedPAC in response to the proposed plan, ASA President Mark A. Warner, M.D., expresses strong opposition to the commission’s draft recommendation. Dr. Warner writes, “While we support permanently fixing the SGR, we believe cutting payment for anesthesia by 5.9 percent each year over the next three years, followed by a freeze in payment would harm patient access to care and does not take into account that Medicare currently pays anesthesiologists only 33 percent of the average commercial insurance payment for the same service.”
The proposed 10 year plan would differentiate specialty physicians from primary care physicians in regards to Medicare payments. For specialty physicians, the draft recommendation would reduce payments 5.9 percent annually in years 2012, 2013 and 2014, followed by payment freezes for the final seven years. Payments for primary care specialties would be exempt from the payment reductions and would instead be frozen at current 2011 levels for the entirety of the 10-year period.
ASA will continue to update members on the latest MedPAC developments.
Click here to read the letter ASA sent to MedPAC.
Anesthesiologists as ACO Leaders
As hospitals, Ambulatory Surgery Centers (ASCs), and physician providers formulate the transparent partnerships the new rules require to participate in an ACO, it is important to be reminded that anesthesiologists are integral providers to achieve the goals of this new ACO concept. Anesthesiologists have been critical players in the initial assessment and on-going management of patient’s care throughout the perioperative and obstetrical arenas. In addition, Anesthesiology has been a champion for patient safety and has contributed data to the Anesthesia Quality Institute (AQI), for years.
Recent professional editorials have talked about creating a “surgical home” or an Accountable Anesthesia Organization as concepts where anesthesiologists would lead a team dedicated to the goals of an ACO. A recent article published in the Journal of the American Medical Association addressed the potential mistakes in implementing ACOs, particularly in failing to recognize interdependencies (http://jama.ama-assn.org/content/306/7/758.full).
It will be interesting to see the CMS response to the final rules for ACOs when they are made available.


