The AASM joins the American Medical Association (AMA) in strongly supporting the Strengthening Medicare for Patients and Providers Act (H.R. 2474), a bipartisan measure now pending in the 118th Congress, which would provide the crucial link between the Medicare physician payment schedule and the Medicare Economic Index, finally putting physicians on an equal fiscal footing with other entities drawing Medicare payment. The AASM will continue to join the AMA and other medical specialty societies in the fight for a financially stable and wholly predictable Medicare physician reimbursement model that protects both providers and the patients they serve. We ask you to join us in urging Congress to ensure that Medicare continues to fulfill its crucial role in safeguarding both the health and financial well-being of tens of millions of Americans. Take action today and urge congress to pass H.R. 2474.
The Need for Medicare Payment Reform
The need for Congress to act quickly and decisively to fix a broken Medicare payment system cannot be overstated. The fiscal stability of physician practices and the long-term viability of our nation’s entire health care system hang in the balance. Sleep medicine providers have experienced continuous reduced reimbursement from the Centers for Medicare & Medicaid Services (CMS) over the years, which has now reached a critical point, threatening to impact quality of care. The AASM is, therefore, partnering with the AMA to advocate for physician payment reform.
Providers need immediate relief from annual funding cuts and fundamental changes to Medicare reimbursement centered on simplicity, predictability, relevance and alignment, principles first outlined in the campaign’s reform principles, shared last fall. The current Medicare physician system reflects none of the reform principles, which needs to change. The government’s own Medicare Economic Index, which gauges the inflation in medical practice costs, will hit 4.5% in 2024, its highest level in two decades. When combined with the 3.8% hike in the Medicare Economic Index recorded in 2023, this translates to an increase of more than 8% in medical practice costs over the span of just two years. Many individual and group physician practices have experienced cost increases well beyond this level, while still seeking a full recovery from pandemic-related setbacks.
Provisions in current law require CMS to implement a 2%, across-the-board reduction in Medicare physician payment rates this year, with another 3.36% cut to the conversion factor scheduled for 2024. This is in direct contrast to the annual payment increases tied to inflation given to hospitals, skilled nursing facilities, and other entities that bill Medicare. Yet physician practices continue fighting to reduce or delay payment cuts nearly every year. Taking inflation into account, Medicare physician payment rates fell 26% from 2001 to 2023, while practice costs rose by 47% over the same period. Physician practices must be placed on sound financial ground, through Congressional action, to fix the Medicare physician payment system.
Questions about the AASM fight for physician payment reform can be sent to coding@aasm.org.
