Physicians 'gravely concerned' about CMS' proposed 3.34% pay cut

The American Medical Association and Medical Group Management Association are among the groups raising concerns over CMS' proposed 2024 Medicare physician payment schedule, which includes a $1.14 (3.34 percent) conversion factor decrease from 2023.

Here are four reactions to the proposed rule: 

AMA President Jesse Ehrenfeld, MD: The proposed Medicare physician payment schedule released today is a critical reminder that patients and physicians desperately need Congress to develop a permanent solution that addresses the financial instability and threatens access to care. The payment schedule estimates the Medicare Economic Index (MEI) increase at 4.5 percent, the highest this century and on top of last year's 3.8 percent. MEI is the government measure of inflation in medical practice costs.

In the face of these growing costs of running a medical practice, physicians have faced the COVID pandemic and increased inflation. Not only have Medicare payments failed to respond, but physicians saw a 2 percent payment reduction for 2023, creating an additional challenge at a perilous moment. For 2024, the new rule indicates there will be another downward adjustment of 3.36 percent.

When adjusted for inflation, Medicare physician payment already has effectively declined 26 percent from 2001 to 2023 before additional inflation and these cuts are factored in. Physicians are one of the only providers without an automatic inflationary increase.

This is almost biblical in its impact. Seven lean years that include a pandemic and rampaging inflation. Physicians need relief from this unsustainable journey.

American College of Rheumatology President Douglas White, MD, PhD: "While the ACR appreciates CMS' continued recognition of the value of complex care provided by rheumatologists and other cognitive care specialists by continuing to operationalize the Evaluation and Management (E/M) coding changes, we are gravely concerned that the proposed rule's physician payment cuts contained in CMS' conversion factor would add to physicians' uncertainty about their continued ability to provide the highest quality of care to Medicare patients. The ACR will review the rule closely and looks forward to working with the CMS and Congress to mitigate the fee schedule's impact on physicians who continue to confront workforce shortages, onerous payer utilization management policies and sustained payment cuts.

MGMA Senior Vice President of Government Affairs Anders Gilberg: The proposed 2024 Medicare Physician Fee Schedule raises significant concerns for medical groups related to its 3.4 percent reduction to the conversion factor, which further increases the gap between physician practice expenses and Medicare reimbursement rates. Medicare already largely fails to cover the cost of furnishing care to beneficiaries, and the proposed cut to the 2024 conversion factor compounds the problem. Implementation of a new add-on code (G2211) for complex patients highlights CMS' flawed approach to addressing inadequate Medicare payments for primary care services using a budget neutral methodology. Congress must reexamine existing law to provide an annual physician payment update commensurate with inflation and do away with Medicare's "robbing Peter to pay Paul" budget neutrality requirements to provide much-needed financial stability for medical practices.

Society of Thoracic Surgeons President Thomas MacGillivray, MD: STS and the rest of the physician community will continue to fight for appropriate Medicare reimbursement that keeps up with inflation. Physicians, including those treating the sickest and most comorbid patients, continue to receive across-the-board cuts, while Medicare continues to increase payments to other healthcare sectors automatically. If Medicare and Congress do nothing to stop these devastating cuts, the health and safety of the nation's seniors will be at risk.

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