Life After the SGR
Could this be the year we finally eliminate the broken Medicare Sustainable Growth Rate (SGR) formula? Years of persistent work by volunteer ACR advocates, working in tandem with physicians from other societies, may finally pay off in 2013. However, we must keep going together until we cross the finish line.
Since it was put in place by Congress in 2002, the SGR payment formula has brought rheumatologists and other physicians to the edge of a steep payment cliff year after year. The cuts called for by the SGR formula have grown over the years, increasing to the point that rheumatologists and other physicians face a 26.5% cut in reimbursements on January 1, 2014, if nothing is done. Congress has continually stepped in, often at the very last minute, to save the day and prevent massive cuts and devastation to patient access. The result has been not only an annual (or more frequent) payment crisis for rheumatology practices, but also years of flat funding, despite the ever-rising costs of practicing medicine and uncertainty about the future.
Through years of dedicated work, rheumatologists and their counterparts in other specialties and subspecialties have succeeded not only in having Congress nearly universally recognize the SGR as a flawed system that must go, but also in driving the conversation about what will eventually replace the SGR.