VIDEO: ACC president says Medicare cuts should be a call to action across healthcare
American College of Cardiology (ACC) President Edward T.A. Fry, MD, an interventional and general cardiologist at Ascension St. Vincent Hospital in Indianapolis, Indiana, and chair of the Ascension National Cardiovascular Service Line, says Medicare cuts for 2023 are a tipping point that need to be a call to action across medicine.
The Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Medicare Physician Fee Schedule (MPFS) Nov. 1. The final conversion factor is $33.06, down from 2022’s conversion factor of $34.61, and reimbursements for cardiology are expected to decrease by approximately 1%. Additionally, the 3% supplemental increase included in the 2022 MPFS has been eliminated.
"It's going to cause a lot of issues for everybody, particularly cardiology. Top of mind are the fee cuts in electrophysiology, which are really draconian, especially with two rounds of cuts over the past two years," Fry explained.
The cuts are significant enough that Fry feels medical societies need to be more proactive with Medicare in presenting alternative payment models
"The bigger picture issue here is that this really has become a tipping point for us to really demonstrate the lack of a rational, constructive and truly value-based approach to physician compensation and payment for healthcare overall," Fry said. "We really need to look at this moment as a clarion call to bring together the entire house of cardiology, as well as the entire house of medicine, to shine a light on this process. I think CMS is open to this as well, because they are going broke."
Fry said CMS's issues are being compounded by an additional 11,000 "mouths to feed" everyday on average as more people turn 65 and qualify for Medicare.
"This is unsustainable percentage of our gross domestic product going to healthcare. We don't have great quality outcomes, as we can see with the life expectancy dropping over the past two years, as well as the continued separation between the U.S. and other developed countries. We really have to do a better job," Fry said.
He said leadership in healthcare needs to come to the table with CMS with possible solutions and ideas for pilot programs to try something different to innovate, because the payment cuts are not sustainable.
He stressed the urgency of the need for change and said government, payers and healthcare organizations need to come together in what he called a Manhattan Project-like effort to address Medicare reimbursements.
"We don't need to frame the problem, the problem here is pretty clear, we need to move on from that to the problem m solving," Fry said.
He said there was a small moral victory in lobbying efforts to get a small increase from the original CMS position to try and return to the traditional RVS Update Committee (RUC) assignment payment values.
"We pushed for more, and that battle may not be over yet," Fry said.
Fry emphasized that the really pressing issues in the CMS cuts are related to the conversion factor, the inherent cuts replicated to the PayGo restrictions, sequestration and budget neutrality.
"These are areas where there is legislation going through Congress right now that may help address these things in the short term," he explained.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com