Medicare Sustainable Growth Rate. “The SGR target is calculated on the basis of projected changes in 4 factors:

1) fees for physicians’ services,

2) the number of Medicare beneficiaries,

3) US gross domestic product, and

4) service expenditures based on changing law or regulations (Hirsch, et al. 2016).”

How have these 4 factors been tied to fiscal performance? Find some additional sources and support your position