AMA Opposes Pay-for-Performance Measures Without Higher Medicare Payments

American Medical Association Executive Vice President and CEO Michael Maves on Monday sent a letter to CMS Administrator Mark McClellan saying that the group will oppose efforts to adopt a pay-for-performance Medicare reimbursement system unless Congress acts to permanently reverse payment cuts to doctors, The Hill reports. According to The Hill, AMA is working to reverse a scheduled 4.3% reduction in Medicare payments to physicians scheduled to take effect Jan. 1.

The Senate has approved a 1% physician reimbursement increase next year to replace the scheduled payment cut, but the House has not passed such legislation. The Senate also has approved a program under which Medicare payments to doctors would be tied to quality improvements, a move that would reduce Medicare costs by an estimated $4.5 billion over five years.

In addition, CMS has launched a voluntary program to encourage doctors to submit information on their outcomes. AMA has said that CMS is moving too quickly to enact a pay-for-performance system and is not collaborating with physician organizations on the issue.

In his letter to McClellan, which also was sent to Congress, Maves said, "AMA support for a value-based purchasing program is contingent upon repeal" of the current formula used to calculate Medicare payments to doctors and its replacement with a system of annual updates that would be tied to the overall cost of providing care.

Such reforms would cost an estimated $154.5 billion over 10 years, according to the Congressional Budget Office. Maves also called for temporary payment increases in 2006 and 2007, with a new system to be installed by 2008. He said AMA then would support establishment of a pay-for-performance system in 2009 (Young, The Hill, 12/7).