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Wyden looks to spur doctor pay overhaul

Senate Finance Chair Ron Wyden

Sen. Ron Wyden. Photo: Drew Angerer/Getty Images

Senate Finance Committee Chair Ron Wyden is seeking to "jumpstart" a discussion of ways to update Medicare doctor fees — and put an end to the yearly ritual of doctors pressing Congress to avert scheduled pay cuts.

Why it matters: Overhauling physician pay could incentivize more coordination of care and peg payments to outcomes, not just the quantity of services provided.

  • But that's been a goal for years, and policymakers have struggled to make lasting changes.

Driving the news: The Finance Committee will hold a hearing on Thursday on the subject and how it affects caring for patients with chronic conditions — a pet cause of Wyden's.

  • Congress used last month's spending deal to partially offset a 3.37% cut to Medicare payments to doctors, but physician groups are pressing for more, noting that they were forced to eat a 2% Medicare pay reduction last year.

What they're saying: "I'm trying to jumpstart a bigger debate about doctors' pay," Wyden told Axios. "You know, because every year you go through, 'Oh, we need to do something, we need to do something.'"

  • "Doctors come and make a good case that they're having problems attracting people to the field," he added. "People back here say, 'Yup, gotta do something,' and then it just kind of goes on."

Wyden wants to build on a 2018 law he worked on with the late Sen. Orrin Hatch to improve how Medicare pays for chronic care.

  • Part of that is extending ideas like reduced cost-sharing for certain high-value services into traditional fee-for-service Medicare.
  • "Traditional Medicare really has not been part of this discussion and we're going to jumpstart the bigger debate around doctor pay with traditional Medicare and chronic care," Wyden said.
  • Witnesses include officials from the American College of Surgeons and American Academy of Family Physicians, whose prepared testimony calls for ideas like increasing physician payments for inflation and better incentivizing participation in alternative payment models.

What's next: Any major overhaul of physician payments faces long odds. If there is a chance, it will likely come in a lame duck session.

  • Still, there could be further activity from the Finance Committee after the hearing, like releasing discussion drafts.
  • And in the House, some prominent physician-lawmakers who are retiring like Reps. Michael Burgess and Larry Bucshon could try to make passage of Medicare doctor pay reforms a legacy issue.
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