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AAMC Submits Comments to Energy and Commerce Committee on SGR Legislation

June 14, 2013—AAMC President and CEO Darrell G. Kirch, M.D., submitted a June 10 comment letter  to the House Energy and Commerce Committee highlighting “specific issues that are of particular interest to academic faculty practices” in response to a request for feedback on draft physician payment reform legislation released May 28 [see Washington Highlights, May 31].

The discussion draft legislation combines comments and suggestions provided throughout 2013 by numerous stakeholders on how to reform the Medicare physician payment system and repeal the sustainable growth rate (SGR) formula.  In the letter, Dr. Kirch thanks committee leaders for their continued efforts and offers the AAMC’s support in designing and implementing “a system that preserves care access for Medicare beneficiaries, responsibly slows the Medicare growth rate, and pays physicians and all providers fairly.”

The draft legislation includes a provision creating an “update incentive program” which places a portion of physician payment at risk based on attaining certain quality measures. Dr. Kirch addressed the administrative burden associated with the current reporting requirements necessitated by numerous quality programs stating, “The legislation must require that the Secretary develop an option for group level measurement and payment.” Noting the numerous clinicians at academic medical centers, Dr. Kirch continued, “When these practices negotiate with private payers, they contract as a group and not by the individual physician.  Medicare should also allow the same option.”

Continuing the focus on streamlining the reporting process, Dr. Kirch said, “We encourage the Committee to consider ways to reduce the administrative burden of coordinating the numerous quality reporting programs and also streamline the EHR Incentive Program so that it can be easily adapted to group-level reporting.”

Dr. Kirch also urged the committee to address the physician shortage, pointing out, “One critical component that often is overlooked in the Medicare payment reform discussion is the need to ensure there are enough physicians to meet the needs of the growing number of Medicare beneficiaries.”   Describing a shortage of more than 91,000 primary and specialty care physicians by 2020, the letter also noted, “These are the doctors that Medicare beneficiaries disproportionately rely upon for health care.” 

To address the shortage, Dr. Kirch said, “It is critical that any effort to reform Medicare physician payment also increases Medicare support for Graduate Medical Education (GME).  I urge you to take this opportunity to address the physician shortage and guarantee provider access to Medicare beneficiaries and all patients by incorporating GME expansion provisions, such as those included in the ‘Training Tomorrow’s Doctors Today Act’ (H.R. 1201) and ‘The Resident Physician Shortage Reduction Act of 2013’ (H.R. 1180), as a key component of any reform legislation.”


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

Courtney Summers
Senior Legislative Analyst
Telephone: 202-862-6042

Ivy Baer, J.D., M.P.H.
Senior Director and Regulatory Counsel
Telephone: 202-828-0499

Mary Patton Wheatley, M.S.
Director, Health Care Affairs
Telephone: 202-862-6297


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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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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806