Prospects Good for Medicare 'Doc Fix'

Tuesday, 10 Dec 2013 10:11 AM

By Lisa Barron

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As Congress heads towards its annual move to pass a stopgap measure preventing drastic cuts in Medicare payment to doctors, lawmakers from both parties are also moving closer to finding a permanent solution to the problem.

A bipartisan plan to change the way the government pays Medicare providers is now moving through the Senate Finance Committee, which is due to vote on it Thursday, and the House Ways and Means Committee.

The momentum to pass the so-called "doc fix" legislation is being driven both by wariness over the ongoing payment patch and a new estimate by the Congressional Budget Office that reduces the cost of reimbursing doctors from roughly $300 billion over a decade to $116 billion, reports The Wall Street Journal.

"From a budgetary standpoint, it's easier now to fix it than it used to be," Mark McClellan, a senior fellow at the Brookings Institution who ran the Centers for Medicare and Medicaid Services under President George W. Bush, told the newspaper.

"To spend all of this time and effort every year to just tread water in place is by no means the best use of everyone's time and effort," he said.

The problem arose from a 1997 congressional act that tied Medicare payment increases to economic growth, leaving a shortfall for doctors as healthcare costs outpaced the economy.

Congress has subsequently avoided the payment reductions on a piecemeal basis; it must do so again by Dec. 31 in order to avoid a 24 percent drop in rates in January, according to the Journal.

The new plan would more closely align payments for Medicare to the quality of care doctors provide based on certain performance measures, moving away from a system where they get a flat fee regardless of how their patients fare, reports The Washington Post.

There is still the issue, though, of how to pay for a permanent "doc fix."

"It's obviously a lot less than it was before. But that's where the debate will be," a Republican Senate aide told the newspaper.

That will likely lead to a short-term fix of a few months to allow Congress a way to find the money to pay for a long-term resolution.

"Talk about a one-year patch would be less conducive to movement," the Senate aide told the Post.

"Three months is a little more conducive and keeps up the momentum."

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