The AAMC submitted a statement for the record (PDF) to the House Energy and Commerce Health Subcommittee before its May 20 hearing, "Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms." In the statement, the association urged Congress to pass the Provider Reimbursement Stability Act (H.R. 8163), which advanced out of the House Ways and Means committee on May 21, and to strengthen Advanced Alternative Payment Models (AAPMs) and reform the Merit-based Incentive Payment System (MIPS) [refer to related story].
The hearing examined the persistent decline in Medicare physician payment, which has fallen approximately 33% in inflation-adjusted terms since 2001, and the structural flaws driving independent practice consolidation. Witnesses testified that the absence of an annual inflationary update tied to the Medicare Economic Index (MEI), combined with budget neutrality requirements that pit specialties against one another, has made independent practice financially untenable for many physicians. Members on both sides of the aisle expressed support for bipartisan legislation to tie physician payments to the MEI.
In its statement, the AAMC highlighted the challenges faculty practice plans at member institutions face under the Medicare and CHIP Reauthorization Act of 2015 (P.L. 114-10, PDF), particularly the annual payment uncertainty that forces difficult decisions around staffing and patient care. The AAMC called on Congress to pass H.R. 8163, which would modernize the budget neutrality threshold, cap year-to-year conversion factor swings at 2.5%, and require the CMS to regularly update direct cost inputs. The association also urged restoration of the 5% AAPM participation bonus, which has effectively expired, noting that Accountable Care Organizations in the Medicare Shared Savings Program have generated $13.3 billion in gross savings since 2012 and outperformed fee-for-service providers on 81% of quality measures.
- Washington Highlights