Medicare payment reform tops agenda as AMA delegates meet

San Diego -- The AMA House of Delegates began its Interim Meeting on Nov. 6 with a call on Congress to address the immediate and long-term problems of Medicare physician payment.

AMA President Cecil B. Wilson, MD, said in an opening-session speech that the Association will work with the new Congress to stabilize Medicare pay for physicians through at least 2011 and seek other payment solutions.

The AMA and other medical organizations are seeking a 13-month patch because they don't expect the lame-duck session, which starts Nov. 15, to approve a permanent solution to the sustainable growth rate formula that determines physicians' Medicare payments. Physician pay is set to go down 23% on Dec. 1 and an additional 2% on Jan. 1, 2011, if Congress does not act.

"Congress needs not only to stop it, but they need to do it in a responsible manner -- for a change," Dr. Wilson said at the meeting at the San Diego Marriott Hotel and Marina. "The nonchalant way they dealt with these cuts in the past year played havoc on physicians' practices.

"Some physicians had to seek loans to meet payroll and keep their doors open. Many deferred their own compensation. All because Congress dithered and delayed," he added.

Dr. Wilson said a repeal of the SGR formula by the end of the year is unlikely, adding that Congress earlier had been too focused on the November elections to act. During the lame-duck session, Medicare pay will compete for attention with many high-profile issues, he said.

"History tells us this won't produce the kind of sweeping reform we need -- and it won't be a pretty sight."

In his 25-minute speech to delegates, Dr. Wilson said the Association will work with the new Congress to develop long-term payment system improvements.

"The priority is to eliminate the SGR. Toss it overboard. Drown that sucker," he said.

The AMA is placing a full-page ad on Nov. 8 in USA Today that urges Congress to act and encourages grassroots action. The same day, the AMA will hold a news conference to discuss how the 25% Medicare pay cut will hurt access to care for the nation's seniors. One in five physicians has been forced to limit the number of Medicare patients they treat, Dr. Wilson said.

One way to improve the health care system is to change how doctors conduct business, he said. The AMA has drafted legislation to give doctors and patients the right to privately contract without penalty to either party. The Medicare Patient Empowerment Act would be an alternative to the SGR formula and ensure Medicare patients' continued access to physician services, according to the AMA.

At the Interim Meeting, which runs through Nov. 9, delegates will address proposals that call for establishing principles for accountable care organizations, creating ethical guidelines for physician use of social media and protecting young athletes from the health dangers of concussions.

Executive Vice President and CEO Michael D. Maves, MD, MBA, also spoke and detailed some of the ways the AMA is working for physicians, including developing resources to help them respond to new payment models being tested in Medicare and to help doctors implement electronic medical records.

Two days before the meeting, the AMA Board of Trustees and Dr. Maves said they mutually agreed that he would step aside when his contract ends on June 30, 2011. Before Dr. Maves' speech, AMA Board of Trustees Chair Ardis Dee Hoven, MD, praised the outgoing CEO's leadership.

Dr. Maves told delegates, "It's the right decision at the right time, for everyone."