Physicians Lobby Hard Against Payment Formula

Physicians Lobby Hard Against Payment Formula

By Rebecca Adams, CQ HealthBeat Associate Editor

Physicians are turning to a formulaic but effective routine to persuade lawmakers to change a Medicare payment formula: The American Medical Association dispatched doctors from 23 states on Tuesday for Capitol Hill visits, four days after a two-week national ad campaign launched.


The payment formula, which most lawmakers agree is flawed, would result in a nearly 30 percent cut in January for physicians if Congress does not block it. In most years over the past decade, lawmakers have staved off the cut temporarily through short-term measures that exacerbate the long-term costs. The 10-year price tag for repealing the formula would now total about $300 billion.


AMA officials are lobbying heavily to persuade Congress to include a major fix to the problem as part of any deficit reduction deal that might emerge from the Joint Select Committee on Deficit Reduction, known as the “supercommittee.” Physicians have scheduled meetings with supercommittee members and physicians who serve in Congress as well as their own representatives.
“Urge them to promote the message that a permanent fix to the physician payment system should be part of any solution to address the budget deficit — failure to act only leads to increased costs in the future,” reads an AMA alert to members.


The television ad campaign started Oct. 7 and will run for two weeks on the national cable television channels CNN and Fox and on broadcast television channels in different markets throughout the nation. A 60-second radio ad also will run in several cities for 10 days. The AMA also commissioned a poll that told 1,000 adults that Medicare payments have been stagnant for a decade, are scheduled for a 30 percent reduction and that “about 1 in 5 doctors say they are already being forced to limit the number of seniors they can care for because of Medicare’s broken physician payment formula.” The poll found that 94 percent of people found the situation very or somewhat serious. The margin of error was 3.1 percentage points.


The AMA campaign comes as other groups, such as the American Osteopathic Association, run ads of their own on the issue. The AOA launched a six-figure campaign with ads on inside-the-Beltway health and political Web sites until Nov. 23, when the supercommittee’s recommendations are due. Radio ads are also running in states such as Maine, Missouri, Michigan, Kentucky, Nevada and Arizona.

Changing the formula is complicated by its massive long-term costs and the offsets that would be needed to pay for it. Recently, the Medicare Payment Advisory Commission (MedPAC) was hit with a swarm of complaints when it compiled a list of potential cuts to Medicare providers that could be considered as options to fund a major change in physician payments.