With a March 31 deadline looming before Medicare payments to physicians are scheduled to decline more than 20 percent, it appears Congress may be considering permanent repeal of the underlying root of the problem rather than yet another short-term patch.

At the heart of the problem is the sustainable growth rate formula, or SGR, that determines how Medicare pays physicians.  For years Congress has applied short-term solutions to the SGR problem and paid for those solutions with short-term spending cuts.  Now it appears congressional leaders are contemplating a permanent repeal of the troublesome formula.

The cost of doing so is about $175 billion for ten years, and Congress reportedly is considering cuts in both benefits and provider payments.

Because many private safety-net hospitals own physician practices, this issue is very important to them.

The Wall Street Journal has taken a closer look at this matter, examining the issue, the stakes, and both the policy and the political challenges congressional negotiators now face.  See its report here.