Rep. Burgess, who is also a doctor, said organizations should focus on ways to address patients with chronic conditions, adding that 80% of Medicare funding is spent by 20% of beneficiaries with chronic illnesses.
Is IPAB the New SGR? Rep. Fred Upton (R-Mich.) raised concerns about the Independent Payment Advisory Board (IPAB), created by the Affordable Care Act. The board sets expenditure targets, on which it bases spending cuts. In 2018, targets will be based on the gross domestic product. "Sounds a lot like SGR, which we’re trying to get rid of," Mr. Upton said. "Since hospitals are exempt from IPAB cuts through the rest of the decade, it seems that the IPAB has the potential to undermine any serious efforts at physician payment reform."
Some panelists agreed.
"It’s not impossible that [the IPAB] could serve a function," Dr. Wilson said, "but as presently constituted, we see it [as] basically another target for physicians to meet – potential double jeopardy, with an SGR as well as the pronouncements from this body."
The panelists also asserted their belief that whatever plan chosen should be physician led, with financial support of the government.
"It would be very helpful if physicians could get better financial support in their own payment system to enable them to lead all of those efforts," said Dr. Mark B. McClellan, director of the Engelberg Center for Health Care Reform and former administrator of the Centers for Medicare and Medicaid Services. "Right now, with fee-for-service staying the way it is, they’re staying behind." Dr. McClellan added that physicians can be the best sources for innovative and cost-saving mechanisms.