On the finish of final 12 months, CMS finalized a fee minimize for Medicare reimbursement to physicians. The CMS Truth Sheet states:
…common fee charges beneath the PFS [Physician Fee Schedule] will likely be decreased by 2.93% in CY 2025, in comparison with the typical quantity these providers had been paid for many of CY 2024
This appears like a modest pay minimize, however the American Medical Affiliation the actual affect is even bigger. CMS studies that the Medicare Financial Index (MEI)–a measure of apply value inflation from workers salaries and wages, workplace area, provides and malpractice–elevated by 3.5%. Thus, with reimbursement falling and apply 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 as a way to shift them to superior various fee fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is only one% in 2027, it can develop to 10.5% over a number of many years.
Traditionally, the Fee has discovered that Medicare beneficiaries had comparable 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.
