Health reform plan includes payment changes

With an eye to curbing self-referral practices and reforming physician payment, U.S. Senate Finance Committee Chairman Max Baucus (D-Montana) has released a healthcare reform plan, according to the American College of Radiology (ACR) of Reston, VA.

The plan suggests moving away from the current sustainable growth rate (SGR) formula that sets reimbursement per medical procedure, and toward a value-driven payment system. It proposes to replace the SGR with a system of multiple expenditure targets for different physician services during the transition to a new payment methodology; using expenditure targets would contain those practices, such as imaging, that are growing faster than others, the ACR said.

The plan also suggests that Congress should investigate the cost and quality implications of self-referral of diagnostic imaging.

In January, Congress will begin discussing an expansion of the State Children's Health Insurance Program (SCHIP), which expires after March 31, 2009. Medicare legislation must be in place by the end of next year to avoid a 20.6% cut in overall physician reimbursement that the current SGR formula mandates, according to the ACR.

Related Reading

CMS avoids tackling self-referral in MPFS and HOPPS rules, November 4, 2008

CMS follows through with new physician fee schedule, July 18, 2008

Congress overrides Bush Medicare veto, July 16, 2008

Bush vetoes Medicare SGR bill, July 15, 2008

President threatens to veto Medicare bill, July 14, 2008

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