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Failure to report, however, could mean up to a 5-percent fee cut starting in 2019. Representative Burgess says the re-


porting requirements are not meant to be additive, and the bill offers some flexibility for physicians who choose to report under other structures. Under a so-called “Payment Choice Program,” for example, eligible physicians and groups could opt out of fee-for-service at any time and participate in approved alter- native payment models such as patient- centered medical homes.


Getting it right The proposal generally reflects a set of core reform principles that AMA, TMA, and other state and national medical so- cieties have advocated to Congress since October of last year for transitioning from the SGR to a new, “high-perform- ing” Medicare system. Log on to the TMA website at www


.texmed.org/SGR_Transition to read the TMA/AMA letter to Congress. Although the SGR must be eliminated, “the physician community recognizes that this is only one-half of the equation,” medicine told congressional leaders in an October 2012 letter. Successful deliv- ery reform that provides patient choice also is a must. So are new payment mod- els that reflect the expense of providing services and efforts to improve quality and manage costs and that are acces- sible to practices of all sizes and settings. It is critical that Congress gets it right, says TMA President Stephen L. Brother- ton, MD. Lawmakers have “finally gotten the idea that you can’t stick a finger in the dike when the hole is 10 by 10. But unless we get something that pays phy- sicians at a level consistent with what it costs to keep our offices open, physi- cians are going to continue to leave” the Medicare program. The legislation “represents continued


progress, though work remains to be done,” AMA President Ardis D. Hoven, MD, said, adding that “the details mat- ter considerably. … Physicians want to move past the failed SGR formula and toward a Medicare program that sup- ports the best health outcomes for their patients and provides a stable, reward- ing practice environment. We will con- tinue to work with the committee and the full Congress this year to improve Medicare for patients and physicians.” Foremost, TMA and AMA recommend that any Medicare payment updates must account not only for the costs of providing services, but also for any ad- ministrative expenses associated with additional quality reporting require- ments. And if the current SGR system is any indication, inadequate funding


“when there’s going to be more people consistently injected into the system is doomed to fail,” Dr. Brotherton said. The proposal to design new methods


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