Doctors Asking Congress to Address Pay in Medicare Legislation

Physician groups are urging Congress to reform Medicare payment structures as lawmakers debate budget measures and debt ceiling negotiations. The American Medical Association and approximately 100 other physician organizations have called for “long-term, substantive payment reforms,” citing significant financial pressures on medical practices.

The Financial Challenge

According to the groups’ advocacy efforts, Medicare reimbursements to clinicians have declined 22% from 2001 to 2021 when adjusted for inflation. Bobby Mukkamala, immediate past president of the AMA Board of Trustees, emphasized the compounding effect: “Our payroll has gone up 20% in the last year.”

Independent medical practices face particular strain from year-to-year payment cuts. Tochi Iroku-Malize, president of the American Academy of Family Physicians, noted that some practitioners may respond by leaving medicine entirely, stating practitioners have mentioned this could “push them into early retirement or changing to a nonclinical career or potentially selling their practice.”

Political Context and Solutions

The timing is significant as Medicare becomes a campaign issue, with both political parties committed to program preservation. Rather than reducing patient benefits, proposed reforms would adjust provider compensation and implement inflation-based rate adjustments.

Recent legislation provided temporary relief through rollback of scheduled physician fee cuts. However, physicians continue advocating for sustainable payment models that allow independent practitioners to remain viable and continue serving Medicare beneficiaries.

Rep. Michael Burgess (R-Texas) acknowledged the challenge, stating that policies should “encourage more physicians to keep or take more Medicare patients.” Without adequate compensation, consolidation pressures continue, with over 50% of physicians now employed by larger health systems rather than owning independent practices.

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