MACRA History; Goodbye, SGR

For more than a decade, physicians pushed for repeal of the Medicare Sustainable Growth Rate (SGR) formula, a flawed mathematical formula written into law that repeatedly targeted physicians for double-digit cuts.  Year after year, Congress would delay or eliminate that year’s cut, sometimes by only weeks at a time.

In 2015, a united physician community joined with Congress, led by ACOG Fellow and US Rep. Michael Burgess, to finally repeal the SGR, replacing it with an entirely new way of paying physicians under Medicare. 

ACOG’s SGR Task Force reviewed and advised ACOG on every repeal-and-replace bill, starting in 2012.  Members of our Task Force, chaired by Mark DeFrancesco, MD, MBA, included James Breeden, MD, Heidi Gray, MD – SGO, Robert Harris, MD –AUGS, Scott Hayworth, MD, Lisa Hollier, MD, MPH, John Keats, MD, CPE, Martin Tucker, MD, and Robert Yelverton, MD. 

Our Task Force helped develop ACOG’s Guiding Principles by which we would measure any SGR repeal-and-replace proposal.  In order for a legislative proposal to win ACOG’s support, it must have:

  • Put in place a simple, coordinated, and transparent new payment system;

  • Coordinate closely with other health care programs

  • Rely on interoperable health information technology  

  • Align quality-measurement programs across payers and rely on risk-adjusted data

  • Encourage ob-gyn development of and participation in innovative care models, e.g. Accountable Care Organizations (ACOs) and medical homes for women

  • Recognize the dual role that ob-gyns may play as primary care and specialty care physicians.

  • Allow for flexibility in practice types, rather than instituting a one-size-fits-all payment system

  • Maintain fee-for-service for ob-gyns with small Medicare populations

  • Ensure reliable payment increases

Email your questions about the MACRA Quality Payment Program to practicemanagement@acog.org

Cost-Conscious Cases:

Physicians have a responsibility to our patients and society to “do no harm” which includes providing cost-conscious medical care.

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American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998