REIMBURSEMENT NEWS: Senate Committee Tackling Physician Payment, Invites Feedback on Key Policy Questions

ASNC is preparing a response to a 29-page white paper released by Senate Finance Committee Chair Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) that highlights pervasive challenges in the Medicare Physician Fee Schedule and seeks stakeholder input on a range of policy questions, including new approaches to updating Medicare physician payment rates and quality measurement. 

The white paper was issued following an April hearing by the Senate Finance Committee that relaunched a discussion of the broken Medicare physician payment system. At the hearing, Chairman Wyden centered his remarks on the need for traditional Medicare fee for service to adopt innovative approaches for chronic disease management. He also called out Medicare Advantage for prior authorization practices, calling them “outrageous.”

Sen. Crapo noted the current Medicare payment paradigm has led to a 25+ percent decline in physician payments over the past two decades even as physicians' overhead costs have skyrocketed. He highlighted the unfairness of physician payment budget-neutrality requirements, which have led physicians to selling their practices or accepting fewer Medicare patients. Sen. Crapo also criticized the Merit-based Incentive Payment System (MIPS), saying it has “buried physicians in paperwork for potential marginal payment bumps based on ambiguous metrics that lack meaning to patients.”

During the hearing, other committee members spoke about issues including telehealth, alternative payment models, food as medicine, and access to care in rural areas. Notably, Sen. Elizabeth Warren (D-MA) remarked that there needs to be a better understanding of what is motivating physicians to sell their practices to private equity investors and called the American Medical Association's Relative Value Scale Update Committee (RUC) a “secretive” process that has favored specialty care.

Important Step Toward Fixing 'Broken' System  
"Together, the Senate Finance Committee's hearing and white paper signal an important start to deliberations on how to fix the broken Medicare physician payment system," says ASNC President Lawrence Phillips, MD, FASNC. "ASNC's Health Policy Committee and Executive Council are carefully considering the policy questions outlined in the white paper and will soon provide feedback to Congress."
Long-term solutions are unlikely to come to fruition this year, so the physician community may be calling on Congress to intervene to prevent anticipated cuts to physician payment in 2025. ASNC urges members to watch for calls to action as well as other advocacy updates reported in Flashpoint.