Congress is working on some bills to eliminate Medicar's SGR (i.e. a permanent "doc-fix"). There's some optimism to get it done now, as opposed to the usual annual (or shorter) temporary patches, because the CBO's cost projections for Medicare are lower than they've ever been, so there's a nice little window to get rid of the SGR at a bargain price.
There are two bills gaining traction now; the first was passed unanimously out of the House Energy & Commerce Committee this summer. A few days ago, the House Ways & Means and the Senate Finance Committee announced their version. Both seem to have strong support, at least in principle, and both basically keep the payment rate flat, and tie traditional fee for service Medicare providers to some quality-based bonuses. Providers who are paid with alternative payment models (e.g. ACOs or bundled payments) get exempted from the P4P measures (i.e. paid more) and the Ways & Means bill gives them a frank pay increase as well. Details in the side-by-side comparison below.
Available as a Google doc here.