The AMA has been on the road fighting for Medicare physician payment reform for well over a decade, and the system remains on an unsustainable path. Temporary patches and ongoing cuts to the Medicare physician payment system have left physician practices and patient access to care at serious risk.
Payment cuts, freezes and redistributions have further exacerbated the challenge. When adjusted for inflation, Medicare physician payment has effectively declined (PDF) 26% from 2001 to 2023.
Despite that stark reality, Congress and the administration are still not focused on fixing the root of the problem—the payment system itself. But it’s time for that to change. It's essential that leaders in Washington work with the physician community on immediate, preventative measures, as well as long-term solutions that will reform the payment model once and for all.
“This cannot wait; we are past the breaking point,” said AMA President Jack Resneck Jr., MD. “Congress must urgently address physician concerns about Medicare to account for inflation and the post-pandemic economic reality facing practices nationwide.
“Our patients are counting on us to deliver the message that access to health care is jeopardized by Medicare’s payment system. Being mad isn’t enough. We will develop a campaign—targeted and grassroots—that will drive home our message,” added Dr. Resneck, a San Francisco Bay Area dermatologist.
To that end, the House of Delegates adopted new policy for the AMA to:
- Declare Medicare physician payment reform as an urgent advocacy and legislative priority for our AMA.
- Prioritize significant increases in funding for federal and state advocacy budgets specifically allocated to achieve Medicare physician payment reform to ensure that physician payments are updated annually at least equal to the annual percentage increase in the Medicare Economic Index.
- Have its Board of Trustees report back to the House of Delegates at each Annual and Interim Meeting on the progress in achieving Medicare payment reform until predictable, sustainable, fair physician payment is achieved.
Learn about how you can take part in the fight to fix Medicare on behalf of your patients and practices at the AMA's Fix Medicare Now website.
Leading the charge to reform Medicare pay is a critical component of the AMA Recovery Plan for America’s Physicians.
The AMA has challenged Congress to work on systemic reforms and make Medicare work better for you and your patients.
Campaign for long overdue change
The House of Delegates also modified existing policy to “implement a comprehensive advocacy campaign, including a sustained national media strategy engaging patients and physicians in promoting Medicare physician payment reform, to achieve enactment of reforms to the Medicare physician payment system consistent with AMA policy and in accord with the principles (Characteristics of a Rational Medicare Payment System) endorsed by over 120 state and medical specialty Federation of Medicine members.”
The AMA—in collaboration with 120 other physician and health care organizations—has outlined the essential principles (PDF), including an annual inflationary update, that can put the nation’s health care system on sustainable financial ground.
Already, a bill has been introduced in Congress to provide annual inflation updates to the Medicare physician payment schedule based on the Medicare Economic Index. That move that is essential to protecting access to high-quality care for the 65 million older adult Americans covered by Medicare.
To help physician advocates and lawmakers get a stronger a grasp on the complicated terrain of Medicare physician payment reform, the AMA has developed a series of explainers that outline problems with the issues mentioned above and offer solutions:
- Medicare physician payment adequacy: Budget neutrality (PDF).
- The Medicare Economic Index (PDF).
- Merit-based Incentive Payment System (MIPS) (PDF).
- Advancing value-based care with alternative payment models (PDF).
The brief explainers lay out the facts for policymakers and physician advocates about these elements of the payment system and why reforms are needed.
Read about the other highlights from the 2023 AMA Annual Meeting.