Medicare & Medicaid

New Congress brings new call for Medicare physician pay overhaul

. 4 MIN READ
By

Kevin B. O'Reilly

Senior News Editor

What’s the news: The AMA is joining nearly 100 organizations that represent a significant share of the nation’s physicians and other clinicians to tell every U.S. senator and representative about the critical importance of calling hearings and working with stakeholders to explore long-term payment solutions for the broken Medicare physician payment system.

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The joint letter from the AMA, American College of Radiology, American Academy of Family Physicians, American College of Physicians and many other organizations comes on the heels of Washington politicians’ failure to stop the entirety of this year’s Medicare pay cuts. Physicians are facing a 2% cut in Medicare payment in 2023, and 2024 will bring at least a 1.25% cut.

Doctors had been staring down as much as 8.5% in 2023 Medicare pay cuts, but an advocacy campaign led by the AMA and joined by more than 150 organizations representing over 1 million physicians and other health care clinicians helped stave off many of the reductions.

“While Congress has taken action to address some of these fiscal challenges by mitigating some of the recent Medicare Physician Fee Schedule (MPFS) cuts, payment continues to decline,” notes the joint letter to Congress. “According to an American Medical Association analysis [JPG] of Medicare trustees data, when adjusted for inflation, Medicare payments to clinicians have declined by 22% from 2001–2021.” 

With the new Congress, the AMA and others are again asking lawmakers on Capitol Hill to “work with us on long-term, substantive payment reforms and urge congressional hearings as soon as possible to begin exploring potential payment solutions to ensure America’s seniors continue to receive access to the high-quality care they deserve.”

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. Our work will continue, fighting tirelessly against future cuts—and against all barriers to patient care.

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Why it’s important: Physicians “face an increasingly challenging environment providing Medicare beneficiaries with access to timely and quality care, which is particularly important for underserved and rural areas,” says the joint letter to members of Congress. “The medical community continues to contend with the residual impacts of the COVID-19 pandemic, a new tripledemic in many regions of the country, record levels of burnout, workforce shortages, and ongoing reductions to Medicare Part B payment and private-payer reimbursement.” 

Moreover, the Medicare physician payment schedule “lacks an annual inflationary update [PDF], even though clinicians—many of whom are small business owners—contend with a wide range of shifting economic factors, such as increasing administrative burdens, staff salaries, office rent, and purchasing of essential technology when determining their ability to provide care to Medicare patients. The absence of an annual inflationary update, combined with statutory budget neutrality requirements, further compounds the difficulties our members face in managing resources to continue caring for patients in their communities.”

All of this together clearly shows “that the Medicare payment system is broken,” says the letter. “These systemic issues will continue to generate significant instability for health care professionals moving forward, threatening patient’s timely access to essential health care services.”

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Learn more: At its most recent meeting, the Medicare Payment Advisory Commission acknowledged the growing gap between the costs of practicing medicine and what Medicare pays.

The AMA—in collaboration with 120 other physician and health care organizations—has outlined the essential principles (PDF) that can put the nation’s health care system on sustainable financial ground.

Visit AMA Advocacy in Action to find out what’s at stake in reforming Medicare payment and other advocacy priorities the AMA is actively working on.

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