Information from: Joaquin Falcon, MLIS – Director, Federation Relations | American Medical Association
On November 1, 2024 the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Calendar Year (CY) 2025 Medicare Physician Payment Schedule. While American Medical Association (AMA) staff continue to analyze and develop a summary of the 3,000+ page rule, we wanted to make you aware of a handful of key issues.
The 2025 Medicare conversion factor will decrease for the fifth straight year by approximately 2.83 percent from $33.2875 to $32.3465. Similarly, the anesthesia conversion factor will be reduced from $20.7739 to $20.3178. This cut is largely the result of the expiration of a 2.93 percent temporary update to the conversion factor at the end of 2024 and a 0 percent baseline update for 2025 under the Medicare Access and CHIP Reauthorization Act. Unfortunately, these cuts coincide with ongoing growth in the cost to practice medicine as CMS projects the increase in the Medicare Economic Index (MEI) for 2025 will be 3.5 percent.
Physician practices cannot continue to absorb increasing costs while their payment rates dwindle. Both the Medicare Payment Advisory Commission and the Medicare Trustees have issued warnings about access to care problems for America’s seniors and persons with disabilities if the gap between what Medicare pays physicians and what it costs to provide high-quality care continue to grow. This is why the AMA and our partners in organized medicine are strongly supporting the bipartisan H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024, which would stop the cut, increase physician payment by one-half of the MEI, and result in a 12-month payment update of 4.73 percent. This bill comes on the heels of 233 bipartisan members of Congress (140 Ds, 93 Rs) cosigning a Dear Colleague letter to House leadership that requested the latest round of cuts be replaced with a payment update that reflects inflationary pressures on physician practices. We are urging all physicians to ask your representatives to cosponsor H.R. 10073.
In addition, following ongoing advocacy by the AMA not to increase the Merit-based Incentive Payment System (MIPS) performance threshold due to significant disruptions caused by the COVID-19 pandemic and Change Healthcare cyberattack, CMS proposed to maintain the threshold to avoid a MIPS penalty of up to 9 percent at 75 points for the CY 2025 performance year/2027 MIPS payment year. Research continues to show that MIPS is unduly burdensome; disproportionately harmful to small, rural, and independent practices; exacerbating health inequities; and divorced from meaningful clinical outcomes. The AMA is strongly urging Congress to make statutory changes to improve MIPS and address fundamental problems with the program by eliminating steep penalties that disproportionately hurt small and rural practices, prioritizing access to timely and actionable data, reducing burden, aligning MIPS with facility quality programs, and incentivizing the development and reporting of new clinically relevant quality and cost measures.
The text of the final rule can be accessed at: https://public-inspection.federalregister.gov/2024-25382.pdf
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