On the finish of final yr, CMS finalized a charge reduce for Medicare reimbursement to physicians. The CMS Truth Sheet states:
…common fee charges below the PFS [Physician Fee Schedule] will probably be lowered by 2.93% in CY 2025, in comparison with the common quantity these providers had been paid for many of CY 2024
This feels like a modest pay reduce, however the American Medical Affiliation the actual affect is even bigger. CMS stories that the Medicare Financial Index (MEI)–a measure of observe value inflation from workers salaries and wages, workplace area, provides and malpractice–increased by 3.5%. Thus, with reimbursement falling and observe value rising the actual reimbursement discount is nearer to six.7% actual reimbursement discount.
Why is CMS doing this? MedPAC notes that CMS could also be aiming to drive down reimbursement for physicians in conventional Medicare fee-for-service so as to shift them to superior different fee fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is only one% in 2027, IT will develop to 10.5% over a number of many years.
Traditionally, the Fee has discovered that Medicare beneficiaries had related entry to care relative to the privately insured, however the bigger hole between MEI progress and PFS updates may negatively have an effect on beneficiary entry sooner or later.
Joe Paduda agrees with this evaluation.