News of Medicare cuts have been spreading like wildfire amongst physicians, from Medicare news, Doximity and Medcentral along with many others. Physicians are up in arms.
Excerpts of this news can be found below from Medcentral, written by Marcia Frellick.
Physicians Blast Medicare’s Proposed 2.8% Pay Cuts for 2025
Under the proposed 2025 Medicare Physician Fee Schedule (PFS), physicians’ base-rate pay would decrease by 2.8%, according to an announcement from the Centers for Medicare & Medicaid Services (CMS) this week.
“It’s really just totally devastating,” Steven P. Furr, MD, president of the American Academy of Family Physicians (AAFP), told MedCentral. “Many practices are struggling to survive. Not only do we not get an inflationary update, but we get a cut on top of that.”
Additionally, without paying family physicians more, “they can’t afford to invest in newer systems and better technologies,” Dr. Furr said. He said an annual inflationary update to keep up with practice costs must be the immediate first action.
Physicians Have to Make a “Really Difficult Choice”
The cuts would affect specialties in different ways. Many rheumatologists, for instance, survive on their (evaluation and management) coding and “they don’t have hospital procedures they can rely on,” said Christina Downey, MD, chair of the American College of Rheumatology (ACR) government affairs committee, in an interview with MedCentral. “This means they may have to make a really difficult choice and decide not to accept Medicare patients anymore. This is not a sustainable situation.”
“Since 2001, the practice cost inflation (the Medicare Economic Index or MEI) has gone up over 50% and yet we keep taking these cuts,” she explained.
Dr. Downey noted that ACR is pushing first for passage of H.R.2474Strengthening Medicare for Patients and Providers Act. While she says that is a huge step in the right direction, “having complete Medicare reform” is the ultimate goal.
AMA Cites a 29% Drop in Pay Since 2001
The American Medical Association (AMA) noted in a statement that the Medicare physician payment effectively dropped 29% from 2001 to 2024 “even before accounting for the newly proposed cut.”
“Physician practices cannot continue to absorb rising costs while their payment rates dwindle,” said AMA President Bruce A. Scott, MD, in the statement. “Rural physicians and those treating underserved populations see this CMS warning as another reminder of the painful challenges they face in keeping their practices open.”
Medicare Reimbursement Has Some Benefits for Primary Care
Though the proposed pay cut drew widespread negative reaction, the proposed rule also includes provisions to ease telemedicine communications, including payment for two-way, audio-only communication in certain situations.
The American College of Physicians (ACP) included in its statement support for the CMS change to the rules surrounding the new G2211 add-on code – which reflects the time, intensity, and practice expense resources involved during office visits that build longitudinal relationships with patients – that would allow it to be billed on the same day as an annual wellness visit, vaccine administration, and any Medicare Part B preventive service. ACP said the change will make visits more comprehensive in addition to reducing billing confusion.
This threat or fear for most physicians accepting Medicare, this is not actually news out of the blue. Back in 2012, I warned about it in a blog post https://www.themedicalstrategist.com/health/speaking-of-health-count-down-til-the-ball-drops/Ironic that this comes on the heels of President Obama announcing a pay raise for members of Congress and himself!
If Congress does not have a “doctor fix” again to thwart a slash in Medicare reimbursement, countless doctors will quit participating in the program leaving both seniors and military families to have less coverage or scrounge to find a doctor that both accepts Medicare and new patients for the Medicare participation.
The American College of Physicians has suggested 3 coping techniques for the decrease in revenue:
*Postpone routine appointments of Medicare patients until a decision has been made and the crisis is averted
*Decrease staff and office hours on a temporary basis
*Apply for a line of credit to tie you over any fiscal hump
Doctors may decide to opt out of participation in Medicare and bill patients directly but if so, must wait two years before rejoining.
These are tough decisions and tough times. The questions are:
- Will Doctors dependent on Medicare, just retire, sell their practice to hospitals or turn the key in the lock and walk away?
- Will Doctors give up on insurance and convert to a concierge model?
- Will this be the end of private practice as we know it?
