Iowa Medical Society Calls on Congress to Modernize Medicare

– Physician leaders from the Iowa Medical Society (IMS) are in Washington today to urge Iowa’s congressional delegation to cosponsor landmark legislation that would strengthen Medicare by updating the program’s troubled payment system.


The SGR Repeal and Medicare Provider Payment Modernization Act of 2014 (H.R. 4015/S. 2000) would transform Medicare into a 21st century program and repeal a fatally flawed formula for determining physician payments – known as the sustainable growth rate (SGR). Congress has until March 31 to enact this bipartisan, bicameral legislation before the SGR formula mandates a drastic 24 percent cut to Medicare physician payments and threatens access to care for Medicare beneficiaries. This legislation is the consensus work of three critical congressional committees on how best to correct what Congress knows is a flawed Medicare physician payment system while moving forward with emphasis on value-based health care delivery and payment.


“We’ve travelled to Washington to ask Iowa’s lawmakers to take the lead in backing this vital legislation, which repeals the broken SGR formula and supports important enhancements in health care delivery,” said Dr. Jeffrey Maire, president elect of IMS. “The clock is ticking. We need decisive support from all our lawmakers to strengthen the Medicare program to provide better health care for Iowa’s half-million Medicare patients and to advocate for value-based payments for Iowa physicians.”

Also while in DC, Iowa’s physicians are asking our state’s congressional delegation to support a permanent 1.0 floor on the Work GPCI adjuster to Medicare physician payment. The three geographic practice cost indexes, or GPCIs, adjust Medicare payment to physicians up or down depending upon the geographic location of the medical practice. Iowa doctors and doctors in other, mostly rural, states hurt by the GPCIs have long argued that the Work GPCI adjuster is based on inaccurate data and expert studies generally agree.


Until better data can be developed, Iowa doctors are asking our state’s delegation to make the 1.0 Work GPCI floor permanent rather than requiring Congress to authorize the floor each year as it has done since 2004. A 1.0 floor means a Work GPIC adjustment of no less than the national average. Without the 1.0 floor Work GPCI floor, physicians in impacted areas like Iowa face a drop in Medicare payment of up to 3 percent.


Just this past week, Congressmen Bruce Braley (D-IA) and Tom Petri (R-IA) were joined by a bipartisan group of 17 members of Congress, including Congressmen Tom Latham (R-IA), Dave Loebsack (D-IA), and Steve King(R-IA), in a letter to House leadership and committee chairs urging the inclusion of a permanent 1.0 Work GPCI floor in any SGR or Medicare “extenders” bill that moves this year. In late December, Senator Chuck Grassley successfully inserted a provision in the Senate’s SGR bill to establish a permanent 1.0 Work GPCI floor.


Congress has long-debated the shortcomings of the SGR policy, resulting in a costly 11-year pattern of fiscal procrastination that has frustrated physicians, threatened patients’ access to care, and created a growing budgetary dilemma from which Congress has struggled to emerge.


Congress has spent $153.7 billion on 16 futile legislative patches to the SGR formula, far more than the cost of permanently reforming the Medicare physician payment system. Congress can no longer afford to spend taxpayer money on stopgap measures that preserve a bad Medicare policy. Now is the time to take a fiscally responsible step forward in creating a higher performing Medicare program.”


IMS wants to work with Congress to move past this broken payment formula and toward a Medicare program that supports innovative payment models that would reduce costs while enhancing the delivery of high-quality, cost-effective care.


During this critical period, patients and physicians are encouraged to go to and take action by asking lawmakers to cosponsor the SGR Repeal and Medicare Provider Payment Modernization Act to foster innovation and remove barriers to the high-quality care that patients deserve.