The American Health Care Association (AHCA) today announced its “enthusiastic support” for the sustainable growth rate (SGR) proposal currently in Congress, a bill that would permanently end the annual rate adjustments known as the “doc fix.”
After issuing 17 doc-fix patches over the past 11 years, Congress proposes to impose a set of fixed cuts across the healthcare industry for 2018 to relevel the baseline and form a solution that will work without annual end-of-year cuts to providers. “For FY 2018, instead of whatever the market basket increase would be for us, it’ll be a hardwired 1 percent. Then in 2019 we’ll get our normal market basket,” said Mark Parkinson, president and CEO of AHCA, in a press conference today about the bill.
The current SGR proposal, he added, is a matter of pay-now or pay-later math. “In the context of a $210 billion package, providers are being asked to pay for $30 billion of it. If this [proposal] falls apart, and there are series of one-year doc fixes going forward, all of those future doc fixes will be paid for with provider cuts. It won’t take many years for our total cut to be more than what it is in this proposed package.”
Some within long-term care may not be happy about the fixed-cut proposal, he acknowledged. “I would understand [other groups’] opposition to this proposal. The prospect of any additional cut, even a cut that is taking place in 2018, is really hard to swallow.” But, he added, without a permanent solution, providers will always be trapped in the annual battles to see which sector of healthcare will take the big hit.
Long-term care will bear the scars of the doc-fix system for a long time to come, Parkinson remarked. “The toll on the skilled nursing sector has been quite damaging. It has created instability for our membership, and the prospect of future doc fixes puts a cloud over the whole sector that makes investment difficult. And most importantly, it has been bad for the residents we take care of.”
The final version on the proposal is expected this week, Parkinson said. Provided the bill’s final language reflects AHCA’s current understanding of the bill and includes additional language to define when therapy reviews are unneccessary, AHCA’s membership will begin a full-court press congressional lobbying campaign as soon as next week.