Nearly 100 professional healthcare societies signed onto a letter dated Feb. 25 requestion Congress include them as legislators work on reforms to the Medicare physician payment system.
"We respectfully request that your committees collaborate with the provider community to immediately initiate formal proceedings (hearing, roundtables, expert panels, etc.) to discuss potential reforms to the Medicare physician payment system to ensure continued beneficiary access to care," the societies requested in the letter.
The societies said they appreciated Congress’ actions over the past several years to mitigate scheduled cuts to the Medicare Physician Fee Schedule (MPFS). But, the letter states, systemic issues such as the negative impact of the Medicare physician fee schedule’s budget neutrality requirements and the lack of an annual inflationary updates to payments continue to generate significant instability for clinicians moving forward. The societies said this threatens beneficiary access to essential healthcare services. The COVID-19 pandemic has also compounded these existing issues, the societies added.
Other challenges cited include the Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP), which have prevented most clinicians from meaningfully participating in the program.
"Nonphysician clinicians are still not fully integrated in the Merit-Based Incentive Payment System (MIPS) because most are ineligible to report cost and promoting interoperability measures, which account for 55% of MIPS scoring," the letter to Congress stated. "The incentive payments have also been historically low, far below the 9% Congress intended, rendering them an ineffective mechanism to offset the reductions required by budget neutrality."
For this reason, the signatories of the letter said it is essential to improve MIPS and Alternative Payment Models, including extending the current incentives for participating in Advanced APMS.
Under the current payment system, many clinicians continue to face steep annual reductions in their Medicare payments, the letter stated. This has largely been due to the inherent instability of the MPFS, coupled with the shortcomings of MACRA’s QPP, which the societies said has created an environment where many practices have seen their payments decrease year-over-year. This decrease in payments has also been compounded by increasing costs and growing inflation.
"Building on the broad bipartisan and bicameral support for recent efforts to mitigate steep payment cuts, our organizations welcome the opportunity to work together to establish a pathway for identifying policy solutions that will ensure long-term stability for the MPFS," the societies concluded in the letter. "Millions of seniors rely on the Medicare program, and we must work to ensure it remains a robust and dependable option for those who need it the most. We remain committed to partnering with Congress to identify and advance necessary reforms and appreciate your continued support of the healthcare clinicians on whom many Americans rely."
AMA pushes for Medicare payment reform
The American Medical Association (AMA) was among the societies that signed the letter, and it has made Medicare physician payment reform one of its key priorities in 2022. The AMA published an update Feb. 25 on its efforts to fix the Medicare pay system once and for all.
The AMA cited the major victory it and other societies had in December 2021 in halting payment cuts from the Centers of Medicare and Medicaid Services (CMS) and said that win forms the basis of this year’s chief legislative focus.
“Stopping the proposed Medicare payment cuts was a major victory, but this yearly cliffhanger must end—the broken record must stop playing,” Bobby Mukkamala, MD, chair of the AMA Board of Trustees, said in the AMA article. “We are calling on Congress to bring about a permanent solution to end the annual battles that threaten the solvency of physician practices.”
The AMA said physicians are facing a continuing statutory freeze in annual Medicare physician payments that is scheduled to last until 2026. After that, payment updates will resume, but only at a rate of 0.25% a year indefinitely, with the society said is not sustainable.
The AMA said there needs to be a reliable Medicare physician payment update that should should keep up with inflation and rising practice costs, while encouraging innovation. The AMA update also said there needs to be new ways to reduce the administrative and financial burdens of MIPS participation.
Medical Societies Asking Congress to be Involved in Medicare Reform:
Academy of Nutrition and Dietetics
Alliance for Physical Therapy Quality and Innovation
Alliance for Recovery Care
Alliance of Specialty Medicine
Ambulatory Surgery Center Association
American Academy of Audiology
American Academy of Dermatology Association
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology — Head and Neck Surgery
American Academy of Physical Medicine & Rehabilitation
American Association of Clinical Urologists
American Association of Neurological Surgeons
American Association of Oral and Maxillofacial Surgeons
American Association of Orthopaedic Surgeons
American Chiropractic Association
American College of Emergency Physicians
American College of Gastroenterology
American College of Mohs Surgery
American College of Obstetricians and Gynecologists
American College of Osteopathic Family Physicians
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiation Oncology
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Gastroenterological Association
American Health Care Association
American Medical Association (AMA)
American Medical Group Association
American Medical Rehabilitation Providers Association
American Occupational Therapy
Association American Optometric Association
American Orthopaedic Foot & Ankle
Society American Osteopathic Association
American Physical Therapy Association
American Podiatric Medical Association
American Psychiatric Association
American Psychological Association
American Rhinologic Society
American Society for Dermatologic Surgery Association
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society for Surgery of the Hand
American Society of Anesthesiologists
American Society of Breast Surgeons
American Society of Cataract and Refractive Surgery American
Society of Colon & Rectal Surgeons
American Society of Diagnostic and Interventional Nephrology
American Society of Echocardiography
American Society of General Surgeons
American Society of Hand Therapists
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Plastic Surgeons
American Society of Retina Specialists
American Speech–Language–Hearing Association
American Urogynecologic Society
American Urological Association
American Vein & Lymphatic Society
Association for Clinical Oncology
Association for Quality Imaging
Association of American Medical Colleges
Association of Pathology Chairs
CardioVascular Coalition
Clinical Social Work Association
Congress of Neurological Surgeons
Dialysis Vascular Access Coalition
Digestive Health Physicians Association
Heart Failure Society of America
Infectious Diseases Society of America
Infusion Providers Alliance
Large Urology Group Practice Association
Medical Group Management Association
National Association for the Support of Long Term Care
National Association of Rehabilitation Providers and Agencies
National Association of Spine Specialists
National Board for Certification in Occupational Therapy
National Center for Assisted Living
Outpatient Endovascular and Interventional Society
Private Practice Section of the American Physical Therapy Association
Radiology Business Management Association
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society for Vascular Surgery
Society of American Gastrointestinal and Endoscopic Surgeons
Society of Gynecologic Oncology
Society of Interventional Radiology
Society of NeuroInterventional Surgery
Society of Nuclear Medicine and Molecular Imaging
The Society of Thoracic Surgeons
United Specialists for Patient Access
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com