On the finish of final 12 months, CMS finalized a charge reduce for Medicare reimbursement to physicians. The CMS Reality Sheet states:
…common cost charges below the PFS [Physician Fee Schedule] might 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 feels like a modest pay reduce, however the American Medical Affiliation the actual impression is even bigger. CMS stories that the Medicare Financial Index (MEI)–a measure of apply value inflation from workers salaries and wages, workplace house, provides and malpractice–elevated by 3.5%. Thus, with reimbursement falling and apply value 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 various cost fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is only one% in 2027, it can develop to 10.5% over a number of a long time.
Traditionally, the Fee has discovered that Medicare beneficiaries had related entry to care relative to the privately insured, however the bigger hole between MEI development and PFS updates might negatively have an effect on beneficiary entry sooner or later.
Joe Paduda agrees with this evaluation.
