Medical groups 'stuck in fee for service' amid CMS pay cuts

Physicians are concerned about Medicare's proposed physician pay cuts for 2024 — which would reduce the conversion factor by $1.14 (3.34 percent) — and argue the lack of clinically relevant alternative payment models available prevents medical groups from transitioning to value-based care,

Seventy-nine percent of medical groups report that Medicare does not offer a clinically relevant advanced alternative payment model for their specialty despite most expressing interest in one for quality measure alignment, according to a MGMA poll published July 19. 

The association argues that the lack of clinically relevant APMs available is a significant barrier for medical groups seeking to transition away from fee for service.

"With physician practices facing annual Medicare payment cuts, they continue to look for APMs that support their efforts to deliver high-quality cost-effective care. Unfortunately, the majority of medical groups do not have a clinically relevant option and find themselves stuck in fee-for-service," MGMA Senior Vice President of Government Affairs Anders Gilberg said. 

"Congress empowered a physician advisory group to vet and advance physician-led alternative APMs, but to date CMS has failed to implement any of its recommendations. As it examines new approaches to payment and quality, CMS must trust physicians to lead these efforts and recognize the best ideas for value-based care won't come from a top-down government approach," Mr. Gilberg said.

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