KHN Morning Briefing

Summaries of health policy coverage from major news organizations

GOP SGR Plan Would Ease Docs Toward Medicare Pay-For-Performance Model

Under its new proposal to replace the Medicare physician payment formula, the House GOP plan would provide physicians with a stable, pre-set fee schedule to allow an eventual transition to alternate payment models. After that transitional period, payments would be linked to performance measures and other quality metrics.

Medpage Today: Congress Moves Forward On SGR Replacement
Physicians' Medicare payments in the future would be based in part on quality metrics relative to their peers, their own performance from previous years, and clinical improvement activities, according to an updated proposal from House Republicans. GOP lawmakers released on Wednesday a more fleshed-out proposal of their plan to repeal Medicare's sustainable growth rate (SGR) formula which determines physician payments and replace it with a plan to reward value and efficiency. … The plan still calls for providing physicians with a stable, predetermined fee schedule for a period of years -- which lawmakers still haven't specified -- to allow providers to transition to alternative payment models. But after that transition, payments would be based on performance measures, which the lawmakers provided more detail on (Pittman, 4/4).

Medscape: House Plan Would Ease Medicare Into Pay-For-Performance
Physician reimbursement in Medicare would gradually shift to a hybrid of fee-for-service (FFS) and pay-for-performance with an option for unspecified "alternative payment models" under a plan that leading House Republicans unveiled yesterday. The plan, not yet in the form of legislation, gives provider organizations such as medical societies the job of developing ways to measure physician performance (Lowes, 4/4).

In other news, Sen. Chuck Grassley has launched a probe into how a political intelligence firm learned about a major shift in Medicare policy before it was officially announced --

The Wall Street Journal: Probes Launched Into Leak of Health Care Policy Shift
A federal agency and a senior senator Thursday launched separate probes into whether news of an important government announcement was improperly leaked to traders about 30 minutes before it was made public. The leak, which was the subject of a Page One story in The Wall Street Journal, caused a run up in stocks of major health-insurance companies in the final few minutes of trading Monday (Mullins, 4/4).

The Hill: Grassley Probes Early Intel On Medicare Advantage Shift
Sen. Chuck Grassley (R-Iowa) is asking how a political intelligence firm learned about a major shift in Medicare policy before it was announced by the Obama administration. Grassley wrote to Medicare chief Marilyn Tavenner Thursday seeking to find out who knew, and when, that the administration would scrap its proposed cut to Medicare Advantage (Viebeck, 4/4).

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