Paying Doctors Less? The Ever-Changing Medicare Physician Fee Schedule.

Medicare is critical to caring for America’s seniors—nearly 1 in 5 Americans rely on it for health coverage! Ensuring that doctors are paid fairly for the important work they do for Medicare beneficiaries is no easy task, but failing to do so could lead to worse care for millions of retirees. 

Medicare uses a fee schedule to determine how much it pays doctors who serve its patients. Each year, the Centers for Medicare and Medicaid Services (CMS) updates this fee schedule, and this year CMS proposed its fifth straight cut. Doctors and patients are worried. 

This proposal would cut reimbursements by 2.8%. At the same time, CMS estimates that the cost of running a medical practice will increase by 3%. That means the cost of running a medical practice is increasing while doctor pay decreases. At a time when costs are up almost 20% since 2021, this is a big problem for doctors as they try to keep up. 

One of the main concerns is that doctors feel like they don’t have any control or input over these changes. The government decides the fee schedule, and doctors just have to accept it. Understandably, this can be frustrating and discouraging. 

Further cuts could make it harder to keep smaller clinics open and would reduce services offered by larger clinics and hospitals. Another major concern is that these pay cuts might make it harder to keep rural clinics open. In many small towns, there is already a shortage of doctors, so when a clinic closes, it can leave patients with nowhere to go for care. With more than 60 million Americans living in rural areas, this is a big issue.  

Many doctors work long hours and do their best to take care of their patients, but lower pay might make it harder for doctors to spend enough time with each patient to provide the highest quality care. Physicians may feel pressured to see more patients in less time just to make ends meet. Some fear that the lost revenue could push providers to opt out of the Medicare program altogether, further reducing access for Medicare beneficiaries. 

The Medicare fee schedule changes may seem like numbers on paper, but they can have real-life effects. In the end, we need to make sure that doctors are paid fairly and responsibly for the important work they do for Medicare beneficiaries. There’s no easy solution, but I can tell you this: Congress needs to act before this problem spells more significant trouble for seniors and providers.