Nearly 100 medical organizations, representing over one million physician and nonphysician health care clinicians, have signed a joint letter dated February 25, 2022, requesting that the leadership of key health care-related committees begin discussions on how to reform the Medicare Physician Fee System (MPFS) update process. The groups recommend that Congressional committees collaborate with the provider community and immediately initiate formal proceedings to discuss necessary reforms to the MPFS to forestall the annual automatic payment cuts that have required last-minute, year-end Congressional intervention.

Due primarily to systemic issues baked into the MPFS payment structure, health care providers would have suffered double-digit payment cuts but for year-end funding the last several years. For example, this past December, Congress concluded the annual frantic ritual of having to intervene at year-end to prevent unwanted cuts in Medicare physician payments in the Protecting Medicare and American Farmers from Sequester Cuts Act. In the closing days of the previous year, Congress acted in a similar fashion to forestall Medicare payment cuts to physicians via provisions added to the Consolidated Appropriations Act, 2021. Each year many of the cuts in MPFS payments result from the application of budget neutrality to overall MPFS payments, resulting in increases for some segments of the physician community which produce cuts for others. 

The medical organizations note the ongoing COVID-19 pandemic has only exacerbated these existing issues with the payment system. Additionally, challenges associated with the Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP) have prevented most clinicians from meaningfully participating in that program. They note also that nonphysician clinicians largely do not participate in the Merit-Based Incentive Payment System (MIPS) because most are ineligible to report cost and promote interoperability measures which account for 55% of MIPS scoring.

One can only hope that the leaders of the Senate Finance Committee, House Ways and Means Committee, and House Energy and Commerce Committee respond affirmatively to the request to collaborate with the provider community by initiating hearings, roundtables, expert panels, and other forums to discuss potential reforms to the Medicare physician payment system to end the MPFS payment roller coaster.