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Message from the President - Dan Beauchamp, MD, FACS -- Congress Permanently Repeals the SGR

(Refer to the American College of Surgeons web site for more information.)

The U.S. House and Senate in landslide votes have passed legislation to permanently stop the broken sustainable growth rate formula (SGR) used to calculate Medicare physician pay. Lawmakers’ bipartisan action stops implementation of a 21 percent SGR cut that was to take effect April 1. The legislation also provides Tennessee hospitals with Federal disproportionate care payments (DSH) for the next 10 years that were provided to all other states except TN until this change.

The SGR was replaced with the Medicare Access and CHIP Reauthorization Act.  Key Provisions of the Act include the following.
  • Full and permanent repeal of the broken sustainable growth rate (SGR) formula used to calculate Medicare physician payments
  • Annual positive updates of 0.5 percent from July 2015 to 2019
  • Maintenance of fee-for-service as a payment option
  • Elimination of current-law penalties from the existing quality programs, such as the Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) Meaningful-Use Program and the Value-Based Modifier (VBM) Program in 2019, and combining these programs into a single Merit-Based Incentive Payment System (MIPS). The merit-based program would be based on physicians achieving a threshold, or benchmark. Such a system makes it possible for all providers who reach these quality benchmarks to achieve positive incentives or payment updates
  • Incentives to move into advanced alternative-payment models (APMs), including 5 percent bonus payments from 2019 to 2024, and exemption from some other reporting requirements
  • Inclusion of appropriate pathways for surgeons to develop, test, and participate in APMs, such as the Clinical Affinity Groups (CAGs) in ACS’s Value-Based Update (VBU) proposal
  • Prohibits CMS from implementing its plan to transition 10- and 90-day global payments to 0-day global payments
  • Clarification that no standard or guideline created under federal health programs shall be construed as setting the standard of care for purposes of malpractice claims.
Frequently Asked Questions

Funding Available for Small/Rural Hospitals to Join Surgical Collaborative   

THA's Tennessee Center for Patient Safety and the TN Chapter of the American College of Surgeons have implemented a surgical improvement project with 21 Tennessee hospitals across the past six years with significant results. The collaborative uses the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), a robust clinical database to track surgical outcomes and mortality. 
Blue Cross Blue Shield Tennessee Health Foundation has offered funding to add new small /rural hospitals to the collaborative for 2015 -2016. The grant stipend would cover approximately 50% of the total cost of participation including program fees and the required clinical abstractor. For more information, contact Chris Clarke at or 615-401-7437. Information on the ACS NSQIP is available and our TSQC website

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