HCR Update from Mark Sanna: 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. Early indications are that the new system will provide for annual payment updates for physicians of 0.5% over five years. 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.