In This Section
Dear Colleague Letter to House Leadership on Medicare Payment Reform Garners Support from More than 100 Members of Congress
August 7, 2023
On June 21, 2023, Representatives Ami Bera, MD (D-CA), Larry Bucshon, MD (R-IN), Kim Schrier (D-WA), Mariannette Miller-Meeks, MD (R-IA), Earl Blumenauer (D-OR), and Brad Schneider (D-IL) sent a letter with support from more than 100 members of Congress to House leadership encouraging action on Medicare payment reform.
The letter highlights the need for an inflation adjustment in the Medicare Physician Fee Schedule as well as more extensive payment incentives to encourage adoption of the value-based care model and combat the consolidation of healthcare practices. In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) to incentivize a shift to quality reimbursement as opposed to quantity or the fee for service payment model. Under the MACRA Merit-Based Incentive Payment System (MIPS), physicians must meet certain quality measures to qualify for reimbursement. MACRA completely eliminated the sustainable growth rate with a goal of streamlining care for patients and reducing administrative burdens on practices and providers.
While the goal of the payment model was to increase patient access and affordability and boost the healthcare workforce, there have been significant issues with utilization as the Alternative Payment Models are temporary and there’s a lack of certainty regarding the threshold to qualify. Notably, the House Committee on Energy and Commerce and Subcommittee on Oversight and Investigations recently held a MACRA-MIPS reform hearing that also highlighted areas of improvement of the program, including ensuring compliance measures are possible in rural populations; however, the consensus from lawmakers seemed to be that reform was not likely this legislative session. We will continue to keep you updated about any movement.
To view the letter, you can do so here: https://bera.house.gov/uploadedfiles/0728_bera_bucshon_medicare_payment_reform_letter_final.pdf