Americans cans must be sick of listening to both sides of the healthcare reform debate. Unfortunately, the debate will continue to rage through at least November.
As someone who follows the debate daily and as part of the industry, I, too, am reaching a certain level of fatigue. The problem is that there isn’t a single solution that, once settled, will make everyone happy — or solve all the problems associated with healthcare. Healthcare and its reform are so complex that it is nearly impossible to focus on any single component and expect a major impact to result.
Consider the topic of SGR, (Sustainable Growth Rate), which we cover in this issue. SGR has been around for years and has gotten more complex as Congress continues to delay taking any real action on reforming the pay formula for physicians. Nobody would argue that Congress “gets it,” but it was hoped that this year they finally were willing to take some meaningful action. Instead, of course, they opted for delaying prospective cuts to doctors’ reimbursements that now total about 25 percent. It seems laughable to think that if the cuts had been enacted that the system could survive a 25 percent reduction. How hard do you think it would have been for a Medicare patient to find a doctor?
But that is beside the real point. There needs to be a core change in the payment formula for doctors, getting away from a fee-for-service model. The proposed initiative went a long way to begin the transformation process. There is still hope that it may be resurrected and ultimately enacted in a form that is close to what had been drawn up.
This issue affects all of you and your customers in a big way. I would argue that many of your customers are so busy trying to deal with so many different things that SGR is something about which they have only a superficial understanding.
As a rep, you can be in position to discuss SGR with your customers. It ties in with the pressures they feel or will feel to integrate themselves into a model (ACO, PCMH, etc.) that provides an alternative payment model tied to value and performance. It is both important and confusing. Make it a point to learn and understand what you can about the issue and be able to provide input and counsel to your customers. They will need it.
Good selling.
Brian Taylor
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