Payment Policy Changes

Orthopaedic surgeons and the physician community are constantly facing cuts to Medicare reimbursement. In 2022, those combined cuts added up to nearly 10% of reimbursement. AAOS advocated fiercely against them and in December 2021, President Biden signed legislation that effectively decreased the cuts from 10% to 2.5% in 2022. However, starting in 2023, Congress fell short of preventing the full 4.5% reduction in Medicare Physician Fee Schedule (MPFS) payments. Instead physicians faced a 2% reduction followed by an additional 1.25% cut scheduled for 2024. Congress did postpone the 4% Pay-As-You-Go (PAYGO) cut. 

The MPFS lacks an annual inflationary update, even though clinicians—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 when determining their ability to provide care to Medicare patients. The absence of an annual inflationary update, combined with statutory budget neutrality requirements, further compounds the difficulties our members face in managing resources to continue caring for patients in their communities. 

Unfortunately, orthopaedic surgeons face an increasingly challenging environment providing Medicare beneficiaries with access to timely and quality care, which is particularly important for underserved and rural areas. The medical community continues to contend with the residual impacts of the COVID-19 pandemic, record levels of burnout, workforce shortages, and ongoing reductions to Medicare Part B payment and private payer reimbursement. Such reform is imperative to sustaining medical practices and ensuring a robust workforce to care for the growing number of America’s seniors.

AAOS is advocating for the 118th Congress to hold Congressional hearings and work with the entire physician community to explore long-term payment solutions.