Congress takes up ritual of the ‘doc fix’

Every year reimbursement rates for physicians fall short. And every year, Congress fills this gap.
This year, the shortfall is the biggest yet. Monday marks the annual ritual of the “doc fix” as Congress will debate whether to approve a $1 billion stop-gap measure. It’s a move that would buy them the month of December to figure out a solution for next year. In 1997, Congress enacted the sustainable growth rate. The idea was this: Medicare spending would grow at about the same rate as other things  – the country’s GDP, physician fees, the number of people enrolled in Medicare.But David Grande, a doctor who studies health economics at the University of Pennsylvania, said this formula was unrealistic.”And the problem is health-care spending has been rising much faster than the economy for decades now,” said Grande.It’s been rising a lot faster. Today Congress is trying to tackle this problem. Representatives can either cut doctor reimbursement rates by about 23 percent or do what they’ve done in years past — implement a stop-gap measure to prevent these drastic cuts.This doesn’t really address the bigger problem, said Grande.”The disheartening thing is that we’re having the same exact discussion year after year and the problem just keeps getting kicked down the road,” he said. “And every year that it gets kicked down the road, the price tag to fix the problem overall gets bigger and bigger.”Grande said fixing the problem will cost about $200 billion. The price tag was so high that it was excluded from the big health-care reform law.   Dr. Fred Ralston, the president of the American College of Physicians, said Medicare payments are often delayed while Congress deliberates reimbursement. “And if you don’t know at any point whether one of your largest payers is going to be able to send you a check or not then that’s very, very difficult for a medical practice to continue with that degree of uncertainty,” said Ralston. “And we think it is time to change the way we do business.”