Cardiology groups push for Medicare reform in face of ‘unsustainable’ payment cuts
Several U.S. cardiology groups are urging Congress to pass new legislation that would refine the Medicare Physician Fee Schedule (MPFS) and provide relief to healthcare providers struggling to keep up with wave after wave of payment reductions.
The American Medical Association (AMA) and nearly 80 other U.S. healthcare organizations, including the American College of Cardiology (ACC), American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions (SCAI), Heart Rhythm Society, Society for Cardiovascular Magnetic Resonance, Society of Cardiovascular Computed Tomography, Society for Vascular Surgery and Society of Thoracic Surgeons, all signed a letter asking House and Senate leaders to prioritize and advance several key bills and legislative proposals that provide greater fiscal stability for physicians and reform key elements of the Medicare Access and CHIP Reauthorization Act.”
All 50 state medical societies signed the letter as well, highlighting the consistent support for these policy proposals found throughout the country.
“The current Medicare Physician Payment System is increasingly unsustainable and the necessary policy reforms can no longer be delayed without severe repercussions for patient access and quality of care,” according to the letter. “The foundational component of strengthening the current payment system is refining the MPFS to accurately reflect the fiscal and clinical realities of medical practice today.”
Context: CMS proposed additional Medicare payment cuts in 2025
Just weeks ago, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule for the 2025 MPFS, which included a 2025 conversion factor reduction of approximately 2.8%. The conversion factor is perhaps the single most important aspect of the MPFS, because Medicare programs are required by law to be budget neutral. CMS can only increase reimbursements for a service if they decrease reimbursements for another service so the budget allocated to Medicare remains balanced.
CMS did say the new conversion factor will not make a significant impact on cardiology services. However, these cuts represent the continuation of a trend the ACC, SCAI other specialty groups have been fighting for years.
The AMA, Medical Group Management Association and others were quick to respond to the payment reductions proposed by CMS, highlighting the importance of Medicare reform.
U.S. medical societies push Congress for change
In their letter, the groups emphasized that CMS continues reducing Medicare payments despite the fact that the “cost of practicing medicine has risen dramatically over the past two decades.” They then urged Congress to pass the Strengthening Medicare for Patients and Providers Act which would connect annual physician payment updates to the Medicare Economic Index (MEI).
“Physician practices, many of which are small businesses, face rising costs for office rent, clinical and administrative staff wages, and professional liability insurance,” according to the letter. “The unfortunate reality is that these costs are not adequately reflected in current Medicare payment rates.”
Another top priority mention in the letter is passing the Provider Reimbursement Stability Act, which would make it possible to look back at prior MPFS conversion factor changes and adjust them when necessary. The legislation would not necessary go back and serve as a “retroactive correction,” the groups noted; it would just help ensure payment policies would be more effective moving forward. If signed into law, the legislation—first put forward in October 2023—would raise the country’s budget-neutrality threshold from $20 to $53 million and then raise it again every five years as necessary based on the MEI.
The groups also pushed policymakers to make multiple changes to the Merit-based Incentive Payment System and Alternative Payment Model policies.
“We stand ready to work with Congress to implement these critical legislative reforms to ensure a sustainable and effective Medicare physician payment system,” the groups concluded.
Read the full letter here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.