Congress July 23 took another step toward eliminating Medicare's current physician payment system when the House Energy and Commerce Health Subcommittee approved draft legislation that would repeal the system and replace it with one based on quality of care measures and new care models.

In a rare show of bipartisanship in the often politically divided House, the panel approved the measure by voice vote. It is expected to be taken up by the full committee the week of July 29.

While Republicans and Democrats mostly agree on what a new Medicare physician payment system should look like, the measure still faces stiff odds of becoming law. That is because lawmakers must find a way to pay for the new system, and there is little agreement on how to accomplish that. The Congressional Budget Office has said freezing physicians' Medicare reimbursement for 10 years would cost $139 billion.