No Medicare reimbursement raises for doctors in 2023: MedPAC

The federal government probably won’t be raising Medicare reimbursements next year, and physician organizations are strongly objecting.

At its January 13 meeting, the Medicare Payment Advisory Commission (MedPAC), which advises Congress on issues pertaining to Medicare, recommended against increasing base payment rates to doctors in 2023. It justified its decision in part by noting that Congress temporarily raised Physician Fee Schedule Payment rates for the period 2020-2022, and that doctors have benefitted from “tens of billions of dollars in pandemic relief funds and more flexibility to provide telehealth.”

Leaders of several groups representing doctors have issued statements criticizing the commission’s recommendation and warning of its financial impact on them and the health consequences for patients. American Medical Association (AMA) President Gerald Harmon, MD said the decision “imperils patient access to high-quality care as the costs to practice medicine continue to rise.”

He added that the AMA’s research shows that, after adjusting for inflation, Medicare physician payment declined 20% between 2001 and 2020. “The discrepancy between what it costs to run a practice and payment is sparking consolidation and driving physicians out of rural and underserved areas,” he said.

George M. Abraham, MD, MPH, president of the American College of Physicians (ACP), said the recommendation would “jeopardize access to primary care physicians.” Despite knowing the importance of primary care, he added, the U.S. allocates between 4% and 6% of its health care resources to primary care, “significantly less than other countries and…what is needed for the United States to achieve a high-functioning health care system that delivers quality and value to individuals and communities.”

He said the ACP wants to work with MedPAC to develop an alternative that would result in stable and predictable reimbursement updates, protect patients’ access to care, and encourage payment and delivery reforms.

The American Academy of Family Physicians issued a statement calling the recommendation “misguided” in light of rising costs and staffing shortages, and noting that institutions such as hospitals and skilled nursing facilities receive annual Medicare reimbursement updates to account for inflation, but physician payment does not.

“A lack of updates to physician payments will worsen access to high quality care, drive consolidation and undermine the stability of primary care physician practices,” the academy said.

The recommendations will be included in MedPAC’s next report to Congress, which is scheduled for March.