Reforming the Medicare Physician Fee Schedule: Controversy and Urgency

Congress is teeing up discussions on a controversial issue that strikes at the heart of the Medicare system: how physicians are paid.

Lawmakers are weighing changes to the Medicare Physician Fee Schedule for the first time since 2015, and host Stephanie Kennan lays out the landscape. She provides background on the pay schedule, describes reforms under consideration, and explains why physicians and other stakeholders are warning about a gap between rising costs and physician payments – which could impact care.

Meet Your Host

Name: Stephanie Kennan

Title: Senior Vice President, Federal Public Affairs at McGuireWoods Consulting

Specialty: Stephanie Kennan helps clients navigate the legislative and executive branches of the federal government to solve problems involving a variety of healthcare policy issues. Her work focuses on providers, medical device manufacturers, drug manufacturers, and associations concerned about Medicare and Medicaid reimbursement.

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Episode Highlights

[00:51] For the first time since 2015, Congress is weighing potential changes to the Medicare Physician Fee Schedule.

[01:03] Reform is driven by the proposed 2025 Medicare Physician Fee Schedule, which would cut physicians’ pay rate by 2.8 percent.

[01:50] Doctors aren’t the only ones concerned about the projected payment schedule; Medicare trustees have issued warnings of their own.

[02:34] How the physician fee schedule works.

[03:16] The Medicare Economic Index, or MEI, figures prominently in payment reform discussions. Here’s what to know about it.

[05:17] An overview of the white paper, released in May by the Senate Finance Committee, proposing that Medicare adjust payments to account for inflation.

[05:38] The white paper outlines opportunities for reform, among them: creating sustainable payment updates to ensure clinicians can own and operate their practices and incentivizing alternative payment models that reward providing better care at lower cost.

[07:16] A bipartisan duo of lawmakers has proposed legislation that, they say, would better support and improve pay for high-quality primary care providers.

[08:05] Their proposal represents a marker for discussions on primary care, and lawmakers have teed up this difficult and controversial issue.

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