Recently the Medicare Payment Advisory Commission (MedPAC) made a misguided recommendation to Congress to continue the Medicare physician payment freeze for calendar year 2023, while at the same time recommending increases for hospitals.
In committing this act of health policy malpractice, the Commission has failed to consider the realities today’s practicing physicians face across all modalities of delivery of care — particularly during a time of COVID, massive staff shortages and skyrocketing expenses.
The Need for An Increase in Medicare Payments
There is a plethora of factors demonstrating the urgent, real-life need for an increase in physician payments. To mention a few:
- After adjusting for practice costs inflation, physician payments under Medicare DROPPED 20% from 2001 to 2020.
- The gap between payment and the cost of running a practice has increased consolidation and caused physicians to flee rural and underserved areas, leaving patients who desperately need healthcare with little or no access.
- There is a 7% increase in the consumer price index. A 0% payment update for physicians is in stark contrast and makes the practice of medicine unsustainable.
- One in five physicians across all delivery modalities is considering leaving practicing within the next two years, given the burnout, stress, unmanageable workload and fear of COVID-19 infection.
- There is an expected 1.5 million increase in Medicare enrollees annually through 2029. If physicians reduce their hours or leave practice as reported, there will not be enough physicians available to deliver care.
- In an environment where inflation is unpredictable and quite high as it is now, it is an issue for physicians in all settings who need to hire and retain staff. Without any boost in payments, staffing will become even more difficult, leading to delays in care.
- For most physicians, it has gone beyond burnout and, in many cases, escalated to a post-traumatic stress disorder-like situation. Seeing patients die from COVID who would normally survive or patients not receive care or die from other causes because beds are being taken by COVID patients is overwhelming.
Out of the 17 MedPAC members, only 6 have a medical degree and none are actively practicing to my knowledge. Without being in the day-to-day trenches, MedPAC is missing the actual reality for doctors and the detrimental impact a zero percent increase will have on patient care. Medpac’s decision to make Medicare payments fall behind overhead will only increase the shortages of physicians and harm access to care. Simply put, no Medicare payment bump will harm both physicians and patients.
What can you do?
Write or call your Congressperson. If you aren’t a member, join the AMA and your local medical society and add your voice to the advocacy team. Be vocal and talk about the issue to others and use social media to spread the word and keep the issue at the forefront. Others need to help advocate for physicians when they cannot advocate for themselves. They just may be saving the life of a loved one.