AMA Warns of “Tsunami” of Threats to Physician Payments

The AMA warns that physicians providing care to Medicare patients could face a “tsunami” of regulatory penalties over the next 10 years, potentially seeing payments cut by more than 13 percent by the end of the decade. The AMA urged the Centers for Medicare and Medicaid Services (CMS) to streamline the competing laws and regulations that threaten access to care.

Next year, some physicians could face cuts of more than 6 percent under the Medicare sequester cut and penalties from overlapping regulatory programs, including the meaningful use electronic health record (EHR) program, the Physician Quality Reporting System (PQRS) and the Value-Based Modifier program (VBM).

Chart showing how overlapping payment adjustments threaten physician practice viability.

The AMA told CMS these programs make it difficult for physicians to invest in health IT and payment and delivery reforms necessary to improve patient care. The AMA urged CMS to simplify and align incentive programs to ensure there is one streamlined process in place for physicians to meet a single set of quality reporting requirements, rather than the three separate sets of requirements that currently exist.

“No other segment of the health care industry faces penalties as steep as these, and no other segment faces such challenging implementation logistics,” the AMA stated in a letter to CMS. “The tsunami of rules and policies surrounding the penalties are in a constant state of flux due to scheduled phase-ins and annual changes in regulatory requirements. In fact, the rules have become so convoluted that no one, including the staff in charge of implementing them, can fully understand and interpret them.”

Read more from the AMA about these threats to physician practice viability.


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