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Lawmakers Finally Ready To Grapple With Looming Physician Pay Cuts
But are they willing to spend enough to prevent a 31-percent shortfall?


If you've been holding your breath waiting for Congress to confront the physician payment disaster on the horizon, then you can exhale at last.

Lawmakers finally considered the options for fixing the troubled physician update formula at a Feb. 10 hearing of the House Ways and Means Health Subcommittee. Subcommittee Chair Nancy Johnson (R-CT) said she's in favor of paying physicians based on their quality of care and asked physicians to come up with suggestions for quality indicators.

"I don't believe the old formula ... can be fixed," Johnson said. "We need to fundamentally rethink the way we pay our doctors." Congress rescued physicians from potential cuts in 2004 and 2005 by mandating payment increases, but didn't address the formula that called for cuts.

One major problem with the current approach: "The best and the worst providers receive the same reimbursement," Johnson said. Already, hospitals are receiving more payments if they report quality measures related to information technology. Now physicians need to step up to the plate and propose their own quality indicators.

Even with a congressional heavyweight like Johnson behind physician payment reform, the issue faces an uphill struggle. Time may be a scarce commodity with battles over Social Security and federal spending on the way.

The subcommittee's top-ranking Democrat, Rep. Fortney "Pete" Stark (CA), said that revamping Medicare physician payment is long overdue. Congress made the situation worse by putting off a real fix, he said. But Stark seems less inclined than Johnson to move quickly toward a pay-for-performance model.