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AAMC Responds to Senate Finance Committee on SGR Reform

June 7, 2013—The AAMC submitted a May 31 comment letter in response to a joint request from Senate Finance Committee Chair Max Baucus (D-Mont.) and Ranking Member Orrin Hatch (R-Utah) seeking health care stakeholder input on Medicare physician payment reform and repeal of the sustainable growth rate (SGR).  The senators asked for specific proposals on how to ensure health care services are valued appropriately, ways to reduce unnecessary services, and how to help physicians transition to new payment models [see Washington Highlights, May 17]. 

In the comment letter, AAMC President and CEO Darrell G. Kirch, M.D., supports the general principles expressed by the Finance Committee leaders, including the importance of moving Medicare to alternative payment models built on quality health care rather than volume.  Dr. Kirch also reinforces the need to address the uncertainty surrounding Medicare physician payment, saying, “As the health care delivery system is undergoing a significant transformation and the current payment system is modified, the AAMC encourages Congress to provide stable and predictable payments during a transition phase.  This will allow physicians to modify their practice behavior and adapt to the changes while still maintaining access to beneficiaries.”

Dr. Kirch also agrees with Senators Baucus and Hatch that additional time is necessary to develop new health care delivery models and offers changes that could be made to the current fee-for-service (FFS) system “to ensure it makes appropriate payments for physician services, reduces unnecessary utilization, and improves quality while also easing the transition to new payment models.”  The letter’s specific recommendations include revising the documentation requirements for cognitive services, incorporating additional care coordination codes, expanding telemedicine services coverage, and continuing efforts to improve the accuracy of relative value unites (RVUs). 

The letter points out AAMC-member institutions have taken the first step in addressing the physician shortage by “increas[ing] their capacity to train new doctors despite the number of federally-supported residency slots remaining stagnant since 1997,” and it is “critical that any effort to reform Medicare physician payment also increases Medicare support for Graduate Medical Education (GME) and we urge you to include ‘The Resident Physician Shortage Reduction Act’ (S. 577) as a key component of any reform legislation.”


Len Marquez
Director, Government Relations
Telephone: 202-862-6281


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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