Moving forward from the sustainable growth rate (SGR) system (3)

The Congress should direct the Secretary to identify overpriced fee-schedule services and
reduce their relative value units (RVUs) accordingly. To fulfill this requirement, the
Secretary could use the data collected under the process in recommendation 2. These
reductions should be budget neutral within the fee schedule. Starting in 2015, the Congress
should specify that the RVU reductions achieve an annual numeric goal—for each of five
consecutive years—of at least 1.0 percent of fee-schedule spending.