AMA opposes CMS, Congress in Medicare pay reduction and related pay-for-performance scheme

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The American Medical Association is none too pleased with the ongoing slide in Medicare payments to physicians, and is also not happy about talk of an adoption of a pay-for-performance Medicare reimbursement model to determine pay levels, The Hill reports.

Michael Maves, executive VP of AMA, sent a pointed letter saying as much this week to CMS Administrator Mark McClennan, which also threatens to oppose the pay-for-performance measures unless Congress moves to permanently reverse the decline in payments to doctors.
           
There is a planned 4.3 percent decrease in Medicare reimbursements to doctors which will go into effect the first of the year.
           
Physicians and lobbyists have steadily voiced concerns in recent years that Congress has not fixed the Medicare system that has been setting continually smaller payment levels, especially given the rise in costs the doctors are seeing. The Senate gave the go-ahead for a plan to give physicians a 1 percent physician reimbursement in 2006 to make up for the pay cuts, though the House has not moved forward with similar legislation.
           
Simultaneously, work by the Bush administration and prominent members of Congress seems to fly in the face of these concerns as they push for ways to reduce spending by moving to what is called "value-based purchasing" in healthcare.
           
Also, CMS has pushed forward a voluntary program to encourage doctors to report their outcomes. In response, the AMA has said that CMS is moving too fast toward a pay-for-performance model and has also not sought physician opinion on the issue.

The AHA letter to McClellan, copied to Congress, states, "AMA supports for a value-based purchasing program is contingent upon repeal" of the existing means by which Medicare payments to doctors are calculated and a replacement with a system of annual updates connected to rising costs of care. The AHA would also like to see a temporary payment increases in 2006 and 2007, with a permanent system in place by 2008, after which the AMA then would support a pay-for-performance system in 2009.