Following a months-long, full-court press by the Texas Medical Association and others in organized medicine, Congress recently considered bolstering Medicare physician payment to ensure vulnerable patients’ access to care for chronic conditions during a Senate Finance Committee hearing on April 11.
The hearing was one of several touch on the subject, with senators from both parties endorsing Medicare physician payment reform.
“In my view, the challenge before the Finance Committee is to improve the way Medicare pays for services delivered in the doctor’s office or at home so there is a laser focus on managing those chronic conditions that are dominating the health of seniors,” Chairman Ron Wyden (D-Ore.) said in his opening statement.
Ranking Member Mike Crapo (R-Idaho) agreed, urging Congress to pass legislation that addresses these payment problems and associated administrative burdens.
“[T]he colossal gap between stagnant fees and steep inflation poses a dire threat to long-term patient access,” he said in his statement. “The current conversion factor update schedule cannot sustain an effective – or even adequate – clinical workforce moving forward.”
TMA has long sounded the alarm over Medicare physician payment, including most recently in an April 11 statement on the hearing sent to U.S. Sen. John Cornyn (R-Texas), a member of the committee.
Even after congressional intervention earlier this year to mitigate a larger Medicare pay cut, physicians face a 1.68% reduction in 2024 because of a much-maligned federal budget-neutrality provision that requires any physician pay increase or decrease to be offsetting, TMA President Rick Snyder, MD, wrote. This cut follows decades of successive reductions.
“[W]hen adjusted for inflation prior to the 1.68% relief in the 2024 budget deal, the payment rate to physicians who care for Medicare patients was 30% less than it was in 2001,” he continued.
The cost of these cuts is high.
“As TMA has communicated before, the inability of Congress to meaningfully address flawed Medicare physician payment policies, combined with rising costs, critically threatens our Medicare patients’ access to health care,” Dr. Snyder wrote. “TMA already has begun to receive reports of practice closures and difficulties referring Medicare patients due to the pressures of the current Medicare payment system.”
To resolve these issues, TMA supports the bipartisan Strengthening Medicare for Patients and Providers Act (House Resolution 2474) by U.S. Rep. Raul Ruiz, MD (D-Calif.), which would provide annual inflationary updates to the Medicare physician fee schedule in line with the Medicare Economic Index, a measure of practice cost inflation, among other reforms.
As of this writing, 10 of the bill’s 127 cosponsors are from Texas.
For more information on recent Medicare changes, check out the Medicare 2024 Payment Update webinar CME, available in TMA’s Education Center.
Emma Freer
Associate Editor
(512) 370-1383