MedPAC recommends 0% physician pay update in 2023, drawing swift rebuke from docs

The Medicare Payment Advisory Commission is recommending a 0% physician pay update for 2023, drawing a swift rebuke from doc groups.

MedPAC approved the decision Thursday, following a staff report back in December deeming current doc pay adequate. The number of clinicians is stable, patient experience scores remain high, commercial rates exceed Medicare reimbursement, and compensation increased between 2019-2020 despite the pandemic, the report noted.

Medicare payments to clinicians dropped by some $9 billion in 2020. However, the decrease was offset by $17 billion in relief funds and $18 billion more in forgiven loans through the Paycheck Protection Program. Commissioners expressed some hesitance about the recommendation but ultimately decided in favor of no pay increase.

“Hard to conceive of a more misguided recommendation to Congress at a time when practices face massive staffing shortages and skyrocketing expenses,” Anders Gilberg, senior VP of government affairs for the Medical Group Management Association, tweeted Jan. 13, while noting that the consumer price index is up 7%.

The American Medical Association said the decision will “imperil” patient access to care at a time when practice costs continue to climb. AMA pointed to its own recent research, which found that Medicare physician payment dropped 20% between 2001-2020. Inadequate reimbursement is spurring consolidation among providers at a time when COVID continues to challenge physician finances.

“Burnout, stress, workload, and fear of COVID-19 infection are leading one in five physicians to consider leaving their current practice within two years. MedPAC’s analysis of payment adequacy relies on trailing indicators and does not account for these canaries in the coal mine,” AMA President Gerald Harmon, MD, said in a statement.

Docs said they appreciated Congress’ action to avert nearly 10% cuts to provider payment in 2022. But they believe more stable annual updates are needed to keep pace with inflation and the pace of innovation in medicine.

The American College of Emergency Physicians called the decision “slap in the face” to frontline providers.

“ACEP strongly believes that a zero percent update to physician reimbursement in CY 2023, which is an update Congress enacted six years ago in the Medicare Access and Chip Reauthorization Act, is artificially low and does not nearly cover the increased cost due to inflation of provider care to Medicare beneficiaries,” President Gillian Schmitz, MD, said Thursday. “Therefore, ACEP strongly encourages MedPAC to reverse course and instead recommend ongoing stable updates to the PFS,” she added later.

MedPAC’s advisory, nonbinding decision is expected to be included in its March 2022 report to Congress.

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