On the finish of final yr, CMS finalized a charge lower for Medicare reimbursement to physicians. The CMS Truth Sheet states:
…common cost charges below the PFS [Physician Fee Schedule] will probably be lowered by 2.93% in CY 2025, in comparison with the common quantity these providers have been paid for many of CY 2024
This seems like a modest pay lower, however the American Medical Affiliation the actual affect is even bigger. CMS studies that the Medicare Financial Index (MEI)–a measure of observe price inflation from workers salaries and wages, workplace area, provides and malpractice–elevated by 3.5%. Thus, with reimbursement falling and observe price rising the actual reimbursement discount is nearer to six.7% actual reimbursement discount.
Why is CMS doing this? MedPAC notes that CMS could also be aiming to drive down reimbursement for physicians in conventional Medicare fee-for-service as a way to shift them to superior different cost fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is just one% in 2027, it’ll develop to 10.5% over a number of many years.
Traditionally, the Fee has discovered that Medicare beneficiaries had comparable entry to care relative to the privately insured, however the bigger hole between MEI progress and PFS updates might negatively have an effect on beneficiary entry sooner or later.
Joe Paduda agrees with this evaluation.
