Payment Policy Changes

Orthopaedic surgeons and the physician community are continuing to face cuts to Medicare reimbursement, even as the cost of practicing medicine continues to grow. This is adding to the long-standing financial pressures physicians already face.

Under current law, physicians are the only part of the health care system that do not receive the kind of annual, inflation-based payment update that is provided to hospitals, nursing homes, and other health care services. Our members—many of whom are small business owners—contend with a wide range of shifting economic factors, such as increasing administrative burdens, staff salaries, office rent, and purchasing of essential technology.  The absence of an annual inflationary update, combined with statutory budget neutrality requirements, further compounds the difficulties they face in managing the resources to continue caring for patients in their communities.

Unfortunately, orthopaedic surgeons face an increasingly challenging environment that is driving physician burnout and pushing smaller independent practices and physicians to be swallowed up by larger hospitals, health care systems and insurance companies. Accelerating vertical and horizontal consolidation in health care reduces competition and threatens patients’ access to high-quality care, particularly in rural areas and low-income and marginalized communities. A permanent fix to bring physician payment into alignment with the actual costs of practicing medicine is the best way to fight back against this consolidation and to ward off potential physician shortages for America’s seniors.

Fortunately, more and more members of Congress are taking notice of the urgent need for a Medicare payment fix, and momentum continues to build with increased discussion in congressional hearings about potential solutions. Now, for the first time, we have legislation, the Strengthening Medicare for Patients and Providers Act (H.R.2474), that would provide an annual, inflation-based update to physician payment.

Ask your member of Congress to cosponsor H.R.2474, which is a critical step towards closing the gap between reimbursements and rising costs for physicians and protecting Medicare beneficiaries’ access to care.