As Super Committee Deadline Approaches, an Update for Physicians

November 14, 2011

The uncertainty surrounding physician payments for Medicare services as a result of deficit reductions could not come at a more inopportune time.

The Joint Select Committee on Deficit Reduction, aka "the Super Committee," is just days from its deadline of November 23 for putting forth a plan to cut federal spending by $1.2 trillion over ten years. 

If it fails to come up with a plan, or if Congress fails to approve that plan, automatic across-the-board spending cuts - including a 2 percent cut to provider reimbursements for Medicare services - will be implemented in 2013.

But the alternative, if the super committee puts forth a plan and manages to secure Congressional approval of it, would not necessarily mean smooth sailing for physicians.

That plan could still include cuts to Medicare providers, it’s just unclear how big, or how small, those cuts would be.

The uncertainty surrounding physician payments for Medicare services as a result of deficit reductions could not come at a more inopportune time.

Physicians are already facing a looming 30 percent cut to Medicare reimbursements thanks to the sustainable growth rate (SGR) formula. That reduction, scheduled to begin Jan. 1, 2012, combined with possible additional reimbursement cuts as a result of the deficit, could be disastrous to physicians and their patients.

“You may have a situation where access not only becomes hard for the Medicare recipient, you may have access be taken away from everybody because there’s no financially good model to make it work,” immediate past AAFP president Roland Goertz, toldPhysicians Practice in August.

That’s because in practices in which Medicare patients make up the majority, physicians wouldn’t be able to withstand cuts to the majority of services they provide. These practices might have to close their doors, not just to Medicare patients, but possibly to the rest of their patients as well.

But there is a possibility that the super committee will put forth a plan that has a positive effect on physician reimbursements - most notably through a permanent repeal of the SGR. That’s something the American Medical Association and nearly 100 specialty organizations are urging it to consider.

“On behalf of hundreds of thousands of physicians and other healthcare professionals, we are writing today to emphasize that it is critically important for the Joint Select Committee on Deficit Reduction to include a full repeal of the fatally flawed Medicare sustainable growth rate (SGR) formula in its final legislation,” the AMA, along with all state medical societies and many specialty societies, wrote in a letter to the committee.

Still, that letter and its arguments may be of little consequence. Analysts, politicians, and the committee members themselves are expressing doubt that it will be able to reach any compromise at all - let alone one that includes an SGR repeal.

"It's at a difficult point," super committee member Sen. Pat Toomey said of the committee’s progress while appearing on Fox News Sunday on November 13. "We've got a ways to go."

And according to the Los Angeles Times, during the same news program, committee member Rep. James Clyburn (D-S.C.) said he is "not as certain" they will come up with a plan.