Physician Medicare payment reform the goal of new congressional working group
Bipartisan members of the U.S. Senate have formed a new working group to brainstorm long-term fixes for Medicare’s flawed approach to physician payment.
Sen. Catherine Cortez Masto, D-Nev., and colleagues announced the initiative on Friday, also highlighting the need to make “necessary updates” to the Medicare Access and CHIP Reauthorization Act of 2015. Commonly referred to as MACRA or the “Permanent Doc Fix,” the legislation has faced various challenges in its implementation.
“As the healthcare system has evolved since the inception of the Medicare program, the physician payment system has failed to keep pace with the actual cost of care and the improvements in new services and technologies,” senators wrote in a Feb. 9 announcement about the effort, posted to Cortez Masto’s website. “Despite efforts like the 2015 Medicare Access and CHIP Reauthorization Act, which made significant strides towards a value-based payment system, further action is needed to address reimbursement challenges and shift toward a system that aligns payment incentives with patient outcomes,” they added later.
Others involved in the effort include Sens. Marsha Blackburn, R-Tenn., John Thune R-S.D., John Barrasso R-Wyo., Debbie Stabenow D-Mich., and Mark Warner, D-Va. Lawmakers emphasized that Congress “must make changes” to the physician payment system and help ensure “financial stability for providers.” They hope their work will help put the federal payment program on course for a more sustainable future.
“This working group is committed to exploring and proposing policy solutions for stable physician payments and necessary updates to MACRA, ensuring sustained access to quality care for patients,” the announcement closed. “We will be reaching out to stakeholders in the coming weeks to seek feedback and to begin developing policies that will address Medicare physician payment for the long-term.”
The new work group comes as physicians grapple with a 3.4% cut to the conversion factor that took effect Jan. 1. Radiology and other specialties have lobbied Congress to reduce or eliminate the pay reduction. In response, Rep. Greg Murphy, MD, R-N.C., had pushed to include his Preserving Seniors' Access to Physicians Act in a continuing resolution to fund the federal government last month. The bipartisan bill would counteract the Medicare conversion factor cut, zeroing out any decrease but not increasing physician pay. However, the bill failed to find passage.
Radiology advocates reacted to news of the working group on Friday. Richard Heller, MD, MBA, noted that, for decades, the conversion factor has failed to keep pace with inflation. This has only compounded pressures practices are facing, including rising costs, labor shortages, and “health insurance companies’ aggressive tactics.”
“Protecting Medicare should not be a partisan issue. Preserving Medicare beneficiaries’ access to care requires reasonable, stable physician reimbursement that reflects the real world in which we practice,” Heller, an RSNA board member and associate chief medical officer for health policy and communication at Rad Partners, told Radiology Business.
The Radiology Business Management Association and American College of Radiology said Friday that they look forward to working with Cortez Masto and colleagues on devising a solution.
“The persistent cuts to the Medicare physician fee schedule have significantly hindered patient access to essential radiology services, underlining the urgent need to halt this detrimental cycle,” said Kit Crancer, president of the RBMA board and senior VP of radiology and public policy partnerships at Rayus. “Moreover, the Merit-based Incentive Payment System, established under MACRA, increasingly marginalizes radiologists, limiting their ability to avoid penalties and diminishing their participation benefits.”
“ACR believes the current Medicare payment system is unsustainable and in need of both long and short-term reform. We look forward to working with the members of this working group and their colleagues to ensure medical services are adequately reimbursed, which would do much to stabilize an already overextended workforce and maintain services,” Cindy Moran, ACR’s executive VP of government relations and economics, told Radiology Business Friday.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.