SGR

As the clock counts down to the so-called “fiscal cliff,” the negotiations between the White House and congressional Republicans reveal just how vulnerable healthcare providers are to potential reimbursement cuts and added policy mandates, as the federal government lurches forward to resolve many unresolved budget and healthcare policy issues

The headline for the ONC’s new proposed rule standards and certification criteria for EHRs 2014 edition, which was rolled out at HIMSS this year, has been all about flexibility. The ONC has envisioned the new certification criteria also giving clearer definitions of certification requirements, promoting progress toward interoperability, and reducing regulatory burden.

Among the most dramatic findings of an MGMA member survey from this summer: among 2,860 groups representing 63,000 physicians in practice, based on the prospect of a 23.6 percent cut scheduled for December 1 in Medicare's sustainable growth rate (SGR), and an additional 6.5-percent cut scheduled for January 1, medical groups plan drastic changes.

One of the issues that the so-called “lame duck” Congress will have to address this month is whether the current extension of the sustainable growth model, or SGR, under Medicare, will be extended yet again, and it’s a problem with immense repercussions for physicians, and ultimately for all of healthcare. If the SGR cuts take effect, it will mean a 23.2 percent pay cut to physicians as of December 1, and a total of more than a 25 percent pay cut as of January 1. (CMS had earlier projected a 29.5 percent pay cut, but on Tuesday, revised downward that estimate to a total 25 percent cut as of Jan. 1, unless nothing is done legislatively.)