Academy of Family Physicians, made little effort to contain his glee Wednesday over the news that Congress had voted to end a reviled payment system for doctors, simultaneously averting a 21 percent physician pay cut and overhauling the way Medicare will pay doctors in the future.
“I just can’t be more positive about it,” said Dr. Wergin, who is a family doctor in rural southeast Nebraska. “The one word is yahoo.”
Then he added: “Now, what next?”
President Obama has signaled that he will sign the bill, resolving an issue that frustrated lawmakers in both parties for more than a decade because it repeatedly required Congress to step in to avert cuts to doctor fees. Doctors and health policy experts have begun to take stock of the practical implications of the legislation, which seeks to move away from paying doctors solely on the volume of their services and toward reimbursing them based on the quality and value of the care they provide. Many said the legislation was short on details about how such quality will be measured, and others expressed apprehension about whether the system will be fair.
“It’s very important legislation in that it aims to support better care and lower costs, but there are a whole lot of details that still need to be filled in,” said Dr. Mark McClellan, a senior fellow at the Brookings Institution and a Medicare administrator in the George W. Bush administration.
Under the new legislation, Medicare will increase the amount it reimburses doctors by 0.5 percent for the next five years. Doctors will earn a 5 percent bonus if they participate in newer payment models that seek to better coordinate care. One example is the so-called medical home, in which a medical team coordinates a patient’s care. They could also work in groups, called accountable care organizations, that receive a set fee to take care of a patient while still meeting quality standards.
“It’s a very big boost to these models,” said Paul B. Ginsburg, a health economist at the University of Southern California, although he and others noted that how these payment models will be defined is still not clear.
Excerpt from NYT, written by Katie Thomas and Reed Abelson, April 15, 2015
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