Verity Healthcare

How huge is the 2025 Medicare charge reduce for physicians? – Healthcare Economist






On the finish of final yr, CMS finalized a charge reduce for Medicare reimbursement to physicians. The CMS Truth Sheet states:

…common cost charges below the PFS [Physician Fee Schedule] will likely be decreased by 2.93% in CY 2025, in comparison with the common quantity these companies had been paid for many of CY 2024

This appears like a modest pay reduce, however the American Medical Affiliation the actual impression is even bigger. CMS experiences that the Medicare Financial Index (MEI)–a measure of apply price inflation from workers salaries and wages, workplace area, provides and malpractice–elevated by 3.5%. Thus, with reimbursement falling and apply price 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 with a purpose to shift them to superior various cost fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is only one% in 2027, it’s going to develop to 10.5% over a number of a long time.

MedPAC writes:

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 might negatively have an effect on beneficiary entry sooner or later.

Joe Paduda agrees with this evaluation.



Post a Comment

Skip to content