Patient care under assault in proposed Medicare Physician Fee Schedule

The proposed Medicare Physician Fee Schedule for calendar year 2023 released this week by the Centers for Medicare and Medicaid Services (CMS) once again jeopardizes seniors' access to critical treatments and procedures, according to the Surgical Care Coalition.

CMS is proposing to cut the Medicare conversion factor—the basic starting point for calculating Medicare payments—by 4.42% for CY2023. As surgical care faces another round of proposed cuts, it is clear that these cuts on top of the sequester cuts threaten patient care and are unsustainable for the long term. Congress must take action to stop another round of cuts, while also stabilizing the system, to protect patients and the care they need.

Surgical leaders across specialties, including ophthalmology, are concerned about the cuts.

"The cost of running a medical practice has increased 39% in the past twenty years. When adjusted for inflation, the impact is a decline in value of Medicare physician payments of 28%," George Williams, MD, American Academy of Ophthalmology Senior Secretary for Advocacy, said in a statement. "On top of jeopardizing patients' access to care, the proposed cuts further exacerbate the difficult operating environment surgical practices already face and the people that are affected most are our patients."

Doug Rhee, MD, American Society of Cataract and Refractive Surgery president, also weighed in on the announcement.

"Annual cuts to reimbursement for surgical care imperils access for seniors to medically necessary and sight-saving and sight-restoring therapies," Rhee said in a statement. "2.3 million Americans last year alone depended on Medicare to receive cataract surgery. Unfortunately, CMS's proposed Medicare Physician Fee Schedule for 2023 poses an even greater risk than in years past to patient access to these and other life-altering interventions."

According to Patricia Turner, MD, MBA, FACS, American College of Surgeons Executive Director, each year, CMS proposes cuts which put access to critical procedures at risk for millions of patients—often the very patients who are most in need of care.

“Today's proposed rule underscores the continued disinvestment in patient care, and the Surgical Care Coalition urges Congress to immediately stop these cuts to protect patients and work toward finding a long-term solution that promotes quality care and investment,” Turner said in a statement.

"Once again, we are facing another year of devastating cuts to a Medicare system that is already ill-equipped to meet the needs of millions of Americans," said John Ratliff, MD, American Association of Neurological Surgeon/Congress of Neurological Surgeons Washington Committee Chair. "The Surgical Care Coalition stands ready to urge Congress to not only stabilize payment levels in the short-term but also transform the system into one that is stable and reliable in the long-term."

Randall M. Clark, MD, FASA, American Society of Anesthesiologists (ASA) President, noted that anesthesiologists, who play a critical and unique role on surgical teams, are facing an unacceptable cut under the proposed fee schedule.

"The need for a more sustainable payments system has never been more evident, and ASA is ready to fight alongside the Surgical Care Coalition to prevent these cuts from taking effect,” Clark said in a statement.

The Surgical Care Coalition advocates for access to quality surgical care for all Americans. The Surgical Care Coalition is comprised of 14 surgical professional associations that proudly represent the more than 180,000 surgeons working across the country with a common goal of improving the quality of care, and quality of life, for all patients.