MGMA recommendations to Congress on improving Medicare payment (April 10, 2024)

April 10, 2024 
 

Re: MGMA Statement for the Record – Senate Committee on Finance’s April 11th Hearing, “Bolstering Chronic Care through Medicare Physician Payment”

Dear Chairman Wyden and Ranking Member Crapo:

On behalf of our member medical group practices, the Medical Group Management Association (MGMA) would like to thank the Committee for the opportunity to provide feedback on bolstering chronic care through Medicare physician payment. We appreciate your leadership in holding this important hearing as it is vital that Medicare adequately reimburse physicians for their chronic care services. Significant reforms are needed to the Medicare physician payment system to stop the harmful yearly cuts and support medical groups’ ability to offer high-quality care to patients with chronic conditions.

With a membership of more than 60,000 medical practice administrators, executives, and leaders, MGMA represents more than 15,000 group medical practices ranging from small private medical practices to large national health systems, representing more than 350,000 physicians. MGMA’s diverse membership uniquely situates us to offer the following policy recommendations.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted to repeal the flawed Sustainable Growth Rate (SGR) formula, stabilize payment rates to physicians in Medicare fee-for-service, and incentivize physicians’ transition to value-based care models. While well-intentioned, MACRA’s methodology for updating the Medicare Physician Fee Schedule (PFS) does not keep pace with rising practice costs and inflation, and simultaneously cuts reimbursement for physicians.

The Centers for Medicare & Medicaid Services (CMS) finalized a 3.37% cut to the Medicare conversion factor in its 2024 Medicare Physician Fee Schedule (PFS). From Jan. 1 to March 8 of this year, medical groups absorbed a 3.37% reduction to reimbursement. Following congressional action to partially mitigate 1.68% of the cut in the Consolidated Appropriations Act of 2024 (CAA, 2024), physician practices are left with a 1.69% reduction for the rest of the year.

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