FOR IMMEDIATE RELEASE ON September 20, 2011
AAN: Congress Must Reform Medicare Physician Payment System to Ensure Access to Care
Letter to Congress Follows MedPAC Proposal to Cut Payment to Physicians
WASHINGTON, DC -
The American Academy of Neurology is calling on the Joint Select Committee on Deficit Reduction to replace the irreparably broken Medicare Sustainable Growth Rate (SGR) formula with a system that more accurately recognizes the value of cognitive, or nonprocedural, care. The American Academy of Neurology, the world’s largest professional association of neurologists, sent a letter today to the Committee as it starts debating the issue to ensure that Medicare patients have adequate access to cognitive specialists like neurologists who often manage chronic conditions. This latest call by the Academy comes on the heels of a recent meeting by the Medicare Payment Advisory Commission (MedPAC), which is considering a recommendation that the cost to replace SGR be passed on to Medicare providers. The Academy does not support such a proposal. “Congress should not take this step as it will severely impact access to care for many of the highest need, highest cost Medicare beneficiaries,” said Bruce Sigsbee, MD, President of the American Academy of Neurology. “However, if Congress is going to look to physicians for savings, any cuts should be based on the services that physicians provide to patients.” While the discussion in Washington has been a debate between primary care physicians and specialists, the Academy is asking Congress to reshape the debate between cognitive (nonprocedural) care vs. procedural care. Cognitive care providers, such as neurologists, frequently coordinate care for Medicare patients and act as principal care providers. Much of their services and the codes they bill for reimbursement by the government are identical to those of primary care providers. “The cut suggested by MedPAC then falls on cognitive care providers as ‘specialists’ simply because of their specialty designation rather than the care they provide. This will result in serious ramifications to patients who are often the highest cost, highest need Medicare beneficiaries who need more expertise to manage their conditions, improve their health, and control costs,” said Sigsbee. According to the Academy, Congress should target the high-cost procedural care where costs are continually driven by high reimbursement that results in increasing volume. Congress should continue to reimburse for cognitive care that often results in prevention of disease and reduces cost, which is performed by primary care providers as well as cognitive care providers like neurologists. The Academy is in favor of a June 2011 report issued by MedPAC that mentioned the end of the SGR could depend on a set of trade-offs to improve the payment system. According to the report, payments for physician and health professionals should be realigned to help ensure an adequate supply of practitioners in cognitive, or non-procedural, specialties who focus on managing patients with chronic conditions. “Since data shows that the neurology workforce will fall 20 percent behind need by 2020, incentives need to be realigned so we can recruit and train enough high-quality cognitive care physicians to treat the growing number of patients with chronic conditions like Alzheimer’s’ disease, stroke, multiple sclerosis, ALS and Parkinson’s disease,” said Sigsbee.
