March 13,2014

Press Contact:

Ken Willis (Wyden) (202) 224-0340

Wyden Urges Needed Medicare Reforms

Seeks to Ends Cycle of Annual ‘Doc Fix’ Crises, Wants Medicare to Shift to Rewarding Quality, Efficiency and Innovation

WASHINGTON –Senate Finance Committee Chairman Ron Wyden, D-Ore., spoke on the Senate floor in support of legislation that resolves longstanding problems with Medicare’s payment formula for physicians, and provides a wide range of reforms that improve care for seniors and increase transparency and accountability. 

“If Congress fails to fully repeal the flawed Medicare payment formula now, I believe there will be cuts to other providers, hospitals, home health care providers, drug companies, skilled nursing facilities,” Wyden said. “Now, I know that this isn't an easy vote for colleagues on either side of the aisle, but it means that we'll be able to accomplish what we were sent here to do - find a way to do what's best for seniors and the doctors who care for them.”

The full speech can be seen here:

A transcript of the speech can be found here

Wyden recently introduced the Medicare SGR Repeal and Beneficiary Access Improvement Act (S.2110).

Summary of the SGR Problem

The Sustainable Growth Rate (SGR) formula – the statutory method for determining annual updates to Medicare’s physician fee schedule – is fundamentally broken. Although originally introduced as a mechanism to contain the growth in spending on physician services, a decade of short-term “patches” has frustrated providers, threatened access for beneficiaries, and created a budgetary dilemma from which Congress has struggled to emerge. Over the last decade, Congress has spent nearly $150 billion on 16 short-term SGR overrides to prevent pending cuts.

The 113th Congress has brought renewed commitment to repealing and replacing the flawed SGR update mechanism. This effort has been helped by the significantly reduced Congressional Budget Office score for a freeze of physician payments over the next ten years and the bipartisan proposal agreed to by all three committees of jurisdiction last month. Building on that effort, this legislation would move Medicare physician payment away from the current volume-based payment system to one that rewards quality, efficiency and innovation.

Highlights of the Medicare SGR Repeal and Beneficiary Access Improvement Act (S.2110)

The proposal would:

  • Repeal the SGR and end the annual threat to seniors’ care, while instituting a 0.5 percent payment update for five years.
  • Improve the fee-for-service system by streamlining Medicare’s existing web of quality programs into one value-based performance program. It increases payment accuracy and encourages physicians to adopt proven practices.
  • Incentivize movement to alternative payment models to encourage doctors and providers to focus more on coordination and prevention to improve quality and reduce costs.
  • Make Medicare more transparent by giving patients more access to information and supplying doctors with data they can use to improve care.
  • Extend current law health care and human services policies that ensure affordable Medicare premiums for low- income seniors and guarantee beneficiaries have access to needed therapy services.