Three congressional committees reached an agreement today on the policy parameters of a bill to reform how Medicare pays physicians–including doctors of chiropractic–but they have not yet decided on how to pay for the replacement.

The deal reached by the Senate Finance Committee, House Energy and Commerce Committee and House Ways and Means Committee represents a major step forward in replacing Medicare’s current payment formula, known as the Sustainable Growth Rate (SGR). Earlier indications are that the new system will provide for annual payment updates for physicians of 0.5 percent over five years. These annual updates are meant to help physicians transition into a new payment system and away from SGR. Medicare providers could also get bonuses by participating in an improved quality program in Medicare’s traditional fee-for-service system, or in alternative payment models.

Without an agreement on how to pay for the bill, however, final passage of a replacement measure is far from assured. Legislators indicated they wanted to reach an agreement on policy before broaching how to pay for it.