This week, the House Committee on Energy and Commerce’s Subcommittee on Health held a two-day hearing on the physician reimbursement rate under Medicare known as the Sustainable Growth Rate (SGR).  Members and witnesses supported a permanent legislative solution, colloquially known as the “doc fix,” to the broken Medicare physician reimbursement formula.  Despite the fact that there is agreement on the need to increase the reimbursement rate, finding a financial offset to pay for the fix continues to be a major delay in finding a permanent solution.  A permanent legislative fix is currently estimated to cost around $140 billion.  Some of the offsets discussed at the hearing this week were increasing the age of eligibility for Medicare, prescription drug reform, the President’s recent proposal to charge wealthier seniors more for Medicare physician services and drug coverage, and streamlining Medicare into a single annual deductible.  Members are working to pass a legislative fix before the current temporary “doc fix” expires on March 31, 2015.  

Like Medi-Cal, physician reimbursement rates for Medicare directly impact patient access to healthcare.  In rural areas, with a disproportionate percentage of retirement age individuals, likely utilizing Medicare, the need to ensure a sufficient pool of providers who accept Medicare is particularly necessary.  The reimbursement rate for physicians is a direct contributor to the availability of these services in rural areas.