Medicare physician payment cuts threaten access to health care

The American Academy of Family Physicians said it is “disappointed” that the end-of-year congressional spending bill “fails to adequately address outdated Medicare physician payment.”

The omnibus bill cuts the 2023 Medicare conversion factor by 2%, according to AAFP President Tochi Iroku-Malize, MD, MPH, MBA, FAAFP.

“Coupled with inflation and rising practice costs, any payment cut puts untenable strain on family medicine and other physician practices. This ultimately worsens beneficiaries’ timely access to care, stalls progress toward value-based care and hastens health care consolidation,” Iroku-Malize said in a statement. “Congress must take action to ensure Medicare physician payment policies support comprehensive and continuous primary care, keep pace with increasing practice costs and stop the annual threat of Medicare cuts.”

According to a press release from the ACP, the 2% cut follows 2 decades without an increase in physician payments, “while inflation continues to be high.”

The AMA estimates that Medicare physician payments declined by 22% from 2001 to 2022 after adjusting for inflation.

“High inflation compounds the threat to practice viability because physicians are the only Medicare providers without annual inflation-based updates. We are deeply worried that many practices will be forced to stop taking new Medicare patients — at a time when access to care is already inadequate,” AMA President Jack Resneck Jr., MD, said in a statement. “Congress must immediately begin the work of long-overdue Medicare physician payment reform that will lead to the program stability that beneficiaries and physicians need.”

Despite the payment cuts, medical organizations applauded other provisions in the legislation, including 2-year extensions for telehealth flexibilities that were introduced during the COVID-19 pandemic.

“This preserves patients’ access to virtual care and offers predictability for physicians,” Iroku-Malize said.

The legislation also includes investments and policies to increase access to mental health care and funding to support the adoption of the Collaborative Care Model, “a small but important step toward expanding behavioral health integration into primary care,” Iroku-Malize said.

“We also strongly support the requirement for states to continuously cover children in Medicaid and CHIP for 12 months — something the AAFP has long advocated for,” she said. “Additionally, the legislation makes permanent a state option to extend postpartum Medicaid coverage for a full year. These changes will improve access to care, help family physicians maintain strong relationships with their patients and help address disparities in child and maternal health.”

References:

• AMA statement on Medicare cuts. https://www.ama-assn.org/press-center/press-releases/ama-statement-medicare-cuts. Published Dec. 19, 2022. Accessed Dec. 27, 2022.
• Family physicians respond to end-of-year health care legislation, urge comprehensive Medicare reform. https://www.aafp.org/news/media-center/statements/family-physicians-respond-to-end-of-year-health-care-legislation.html. Published Dec. 23, 2022. Accessed Dec. 27, 2022.
• Internal medicine physicians say Congress’ approach to Medicare payments falls short of protecting access. https://www.acponline.org/acp-newsroom/internal-medicine-physicians-say-congress-approach-to-medicare-payments-falls-short-of-protecting. Published Dec. 20, 2022. Accessed Dec. 27, 2022.
• Medicare physician payment is not keeping up with inflation. Why are physician services taking a backseat? https://www.ama-assn.org/sites/ama-assn.org/files/2022-09/medicare-updates-inflation-chart.jpg. Accessed Dec. 27, 2022.