Healthcare groups prod Congress to stop CMS' payment cuts
AMGA and the AMA said the proposed cuts would hinder the ability of multispecialty medical groups to provide high-quality care to their patients.
Photo: John Baggaley/Getty Images
Healthcare and doctors' groups are unhappy with the Centers for Medicare and Medicaid Services' proposed cuts to physician payments in its annual fee schedule, and are calling on Congress to intervene, hoping to stave off a 3.34% cut to the fee schedule's conversion factor – used to calculate Medicare payments to doctors.
Trade association AMGA said the proposed cuts would hinder the ability of multispecialty medical groups and integrated systems of care to provide high-quality care to their patients.
If left unaddressed, the cuts would exacerbate the financial pressures facing AMGA members, as Medicare physician payments already are not keeping up with the increasing cost of delivering healthcare, AMGA said.
AMGA members cannot absorb this proposed payment cut," said AMGA President and CEO Dr. Jerry Penso. "Their expenses are continuing to increase, and Congress needs to act to ensure Medicare's reimbursement reflects the cost of delivering high-quality care to patients. We're concerned AMGA members may be forced to make tough decisions on staffing and the services they can offer to their communities if proposed cuts are left unaddressed."
WHAT'S THE IMPACT
The American Medical Association also went on record as opposing the cuts, calling the physician payment schedule a reminder that patients and physicians "desperately need Congress to develop a permanent solution that addresses the financial instability and threatens access to care."
"In the face of these growing costs of running a medical practice, physicians have faced the COVID pandemic and increased inflation," said AMA President Dr. Jesse Ehrenfeld. "Not only have Medicare payments failed to respond, but physicians saw a 2% payment reduction for 2023, creating an additional challenge at a perilous moment.
"When adjusted for inflation, Medicare physician payment already has effectively declined 26% from 2001 to 2023 before additional inflation and these cuts are factored in," he said. "Physicians are one of the only providers without an automatic inflationary increase.
"This is almost biblical in its impact," said Ehrenfeld. "Seven lean years that include a pandemic and rampaging inflation. Physicians need relief from this unsustainable journey."
The AMA said that momentum is building for reform, noting that in January the Medicare Payment Advisory Commission recommended a physician payment update tied to the Medicare Economic Index (MEI) for the first time. And in April, a bipartisan group of House members introduced a bill that would provide annual inflation updates to the Medicare fee schedule based on the MEI. At the AMA's recent Annual Meeting, physicians from across the country called for a campaign to address this situation.
"These increasingly thin or negative operating margins disproportionately affect small, independent, and rural physician practices, as well as those treating low-income or other historically minoritized or marginalized patient communities," said Ehrenfeld. "Piling on more cuts is an unsustainable approach. Congress needs to turn its attention to fixing Medicare so we can preserve access for patients."
The AMA has developed a set of principles to guide efforts on Medicare physician payment reform, part of the AMA's Recovery Plan for America's Physicians.
THE LARGER TREND
While AMGA decried the cuts, it commended CMS for proposing reimbursement policies that treat telehealth care as equivalent to in-office care, saying that the cost of treating patients through telehealth does not differ from an in-person visit.
The rule, said Penso, builds on the lessons learned from the COVID-19 public health emergency, which demonstrated how vital telehealth care is to providing access to high-quality healthcare.
"Providing telehealth services is as labor- and time-intensive as an in-person visit," said Penso. "It simply isn't the case that telehealth is a less expensive way of treating patients, and this proposal is a welcome development. Patients expect telehealth to be available, and today's rule will help ensure it remains a viable option for AMGA members and their patients."
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
