Economists and scholars defend Medicare pay board

Supporters say the IPAB is necessary to cut costs and improve care. The AMA and other critics say it could implement SGR-like pay cuts.

By Charles Fiegl — Posted June 2, 2011

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

More than 100 academics, analysts and economists are pressing Congress to preserve the Medicare Independent Payment Advisory Board to promote new payment methods and improve the program.

Momentum has been building in Washington, led by House Republicans, to pass legislation that would repeal the board as authorized by the health system reform law. A House bill sponsored by Phil Roe, MD (R, Tenn.), has 120 co-sponsors, including several Democrats, who support eliminating the IPAB. President Obama instead has called for the cost control board's charter to be expanded in an effort to curtail Medicare spending growth.

A letter from 106 professionals at universities and think tanks across the country urges lawmakers to keep the board intact.

"The IPAB is a tool designed to help the Congress slow the rapid projected increases in health care costs in the federal budget and to improve the delivery of health care," the May 20 letter states. "Increases in Medicare, Medicaid and the private sector could be slowed by giving providers greater incentives to adopt more cost-effective treatments and prevention interventions."

Congress should "mobilize the expertise of professionals" who can study payment policy and would propose solutions to problems plaguing the system, the letter continued.

The letter's signatories include physicians Shari Bolen, MD, MPH, of Case Western Reserve University, Cleveland; Nancy Keating, MD, MPH, J. Michael McWilliams, MD, PhD, and Michael Wilson, MD, of Harvard Medical School, Boston; William Sage MD, of the University of Texas; Barbara Starfield, MD, MPH, of Johns Hopkins University, Baltimore; and William Terry, MD, of Brigham and Women's Hospital, Boston.

The American Medical Association and other physician organizations have significant concerns about the IPAB. The board would establish another arbitrary system with the potential for imposing doctor pay cuts similar to those mandated by the sustainable growth rate formula, the AMA has said. The Association has urged Congress and the Obama administration instead to work together on reforms that strengthen Medicare instead of handing off decisions to an unelected board.

Analysis by conservative groups, such as the Heritage Foundation in Washington, D.C., have concluded that the IPAB would fail to control costs. Under current law, Congress has prevented SGR cuts to Medicare since 2003, and lawmakers likely would override future cost control measures that adversely affect physicians and patient access, the foundation said.

Some Republican opponents in the Senate have vowed that the GOP will block the nomination of any official to the IPAB if the board is still in place in 2014, when it is scheduled to launch.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn