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Sustainable Growth Rate: an unsustainable saga

June 3, 2008

The SGR — a zero-sum game for physician reimbursement under Medicare which guarantees year-over-year lower unit prices — has got to go.  Time has run out on the last stopgap measure, and el presidente promises to veto the current fix (which has to take effect by July 1, or else docs get hit with a 10.6% haircut) because Sen. Max Baucus has put together a package that will hold back the SGR cuts by cutting Medicare Advantage rates.  While there are two sides to every story, it is hard to understand the logic behind paying MCOs 12% more than the cost of traditional Medicare, and the resources directed at those MCOs certainly have other potential uses: paying docs, for example. 

This is just one of the myriad Rube Goldberg-esque constructs that could be swept away by some wholesale health care reform plan — but don't hold your breath.

— David Harlow

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Filed Under: CMS, Health care policy, Health Law, Managed Care, Medicare, Physicians

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