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Put This on the End-of-Year To Do List

November 17, 2014
9:57 am

There are not high expectations for this lame duck session of Congress.  We may see passage of a bill to authorize the Keystone XL pipeline and there will have to be action on a spending bill to keep government operating as well as funding measures related to the fights against Ebola and the Islamic State.  But, when an election sees one party take over control of one or both houses of Congress, the new victors are usually content to put issues on hold until January when they have greater leverage over the outcomes.

Before the waning days of the 113th Congress elapse, however, there is one more critical item that lawmakers should include on their to-do list.

It’s high time to reform the Medicare payment system for physicians and other healthcare professionals.

Sixteen times since 2003, Congress has passed temporary fixes to prevent healthcare providers from having to absorb a significant reduction in their Medicare reimbursements.  This patchwork approach isn’t fair to physicians, patients or taxpayers.  Physicians should not have to wait year after year to find out if Medicare will provide a fair payment for treating beneficiaries.  Patients don’t benefit from a system that doesn’t encourage healthcare professionals to provide better, evidence-based care at sustainable costs.   And taxpayers have had to pay substantially more for these short-term patches than they would have if a sensible, permanent payment system had been implemented in the first place.

There’s no reason this indefensible situation should continue.  In fact, it shouldn’t even be kicked over to the next Congress.

Legislation has been developed in both the House and Senate that would not only permanently fix the Medicare physician payment formula, but would also establish a structure to encourage coordinated care and reward healthcare providers for elevating the quality and cost-efficiency of patient care.  This legislation has support from both Republicans and Democrats.

Further, there is widespread support in the healthcare and patient communities to act now instead of later.

The new Congress will have plenty on its plate next year.  Fixing the Medicare payment formula should become a 2014 achievement, not a 2015 challenge.