Feb. 9, 2024: Medicare Payment Reform Advocacy Update

. 3 MIN READ

The AMA’s Fix Medicare Now website is a one-stop-shop for everything you need to know about the flawed Medicare payment system and how it can be fixed.

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    Stay current on the latest on the issues impacting physicians, patients and the health care environment with the AMA’s Advocacy Update newsletter.

    Continually updated with new content, the site contains all the resources you need to advocate on behalf of your practice and your patients—including:

    • The ability to take action by emailing your members of Congress
    • A “share your story” feature
    • Toolkits on how to be a more effective advocate on social media
    • An interactive timeline
    • A patient reception-area flyer with a QR code where patients can take action
    • A robust resources page with background information, charts, advocates’ letters to Congress and much more

    Unfortunately, the flawed Medicare physician payment system is not going to fix itself. It is going to take action from advocates like you to persuade Congress to do the right thing and address these very real and pressing issues.

    If Congress does not act soon, the most recent 3.37% cut that went into effect on Jan. 1 will become permanent. The most recent continuing resolution, which keeps the government funded until early March, extended the deadline for the final 2024 appropriations package—the last best hope in reversing this cut.

    Please join the fight to fix the broken Medicare payment system today by visiting Fix Medicare Now and let Congress know that America’s physicians demand action before it is too late.

    In a letter (PDF) to the Centers for Medicare & Medicaid Services (CMS), the AMA outlined recommendations to improve Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), which are an alternative reporting option to fulfill MIPS reporting requirements. To date, there are a limited number of MVPs, but CMS is working to expand the portfolio of pathways with the hope to transition MIPS to MVP reporting in the future. Specifically, the AMA strongly urged the agency to revise MVP candidates to be more meaningful and directly beneficial to both physicians and their patients. For example, the Surgical Care MVP Candidate attempts to lump numerous, unrelated surgical specialties (e.g., general surgery, neurosurgery, cardiac surgery, breast surgery) into a single MVP. This is not only inappropriate from a clinical perspective, but it will create confusion and discourage movement into MVPs among surgeons, who might assume that CMS plans to evaluate their performance against other unrelated surgical specialties, pitting one specialty against another.

    Furthermore, the AMA urged CMS to remedy flaws in the cost measures that are included in MVPs; to use the MVP framework to test new scoring policies that effectively address shortcomings in both quality and cost measures, especially “topped out” measures and cost measures with little variation; and adapt population health measures specifically for each MVP, ensuring they are relevant and contribute to meaningful improvements in patient care outcomes. Because the cost measures now account for 30% of final scores for all MIPS participants, the AMA is urging CMS to ensure they are not unfairly reducing Medicare physician payment and to leverage MVPs to improve the cost measure scoring methodology, such as establishing a range of reasonable costs for physicians who provide high-quality care.

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