In early November 2024, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that slashes physician reimbursement by 3.4% in 2024, following a 2% payment reduction for physicians in 2023. Physician advocacy groups, including the AMA, have long criticized the downward adjustment of Medicare payments, which far outpaces the rate of inflation.
The speakers further emphasized how unsustainable these cuts are for all physicians, particularly for independent practices that provide care to the majority of Medicare patients. Mr. Askew underscored that although historically the Medicare Payment Advisory Commission has not identified physician payments as an area needing reform, this year, they too have issued a strong recommendation to Congress, stating that Medicare payment cuts will contribute to workforce stress and decreased access for patients. Although there is legislation (H.R. 2474) that has been introduced that could potentially stabilize Medicare payments year-to-year, Congress is currently facing a looming shutdown. Mr. Askew stated that he did not believe a legislative solution to this issue is likely before the end of the year. He encouraged all physicians to take an active role in the advocacy process by reaching out to Congressional representatives to express their frustrations associated with Medicare payment cuts.
Physician wellness and burnout remains another top concern for the AMA. Mr. Blaney-Koen cited data published in JAMA Network Open that suggested an increasing burnout rate following the COVID-19 pandemic. Burnout continues to be a crisis, as it significantly impacts the workforce shortage issues that patients are facing. Although the 2023 residency match saw record numbers of applicants, there are still projected shortages for 2034, and a significant number of physicians are leaving clinical care. Up to one-third of physicians express a desire to pursue non-clinical careers; therefore, to address workforce issues, Mr. Blaney-Koen stressed the need to improve the quality of life and wellness within the field.
Lastly, the speakers addressed the increasing trend of legislation that encroaches upon the physician-patient relationship, such as laws that penalize physicians for performing gender-affirming care and reproductive healthcare procedures. In both cases, the AMA has joined lawsuits to declare these laws unconstitutional. However, the continued assault on practice autonomy has become a major barrier for physicians.
Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center during the 2023 AMA Interim Meeting, Nov 10 to Nov 14
References:
- Ortega MV, Hidrue MK, Lehrhoff SR, Ellis DB, Sisodia RC, Curry WT, Del Carmen MG, Wasfy JH. Patterns in Physician Burnout in a Stable-Linked Cohort. JAMA Netw Open. 2023 Oct 2;6(10):e2336745. doi: 10.1001/jamanetworkopen.2023.36745. PMID: 37801314