Congressman Brett Guthrie, Chairman of the House Committee on Energy and Commerce, and Congressman Morgan Griffith, Chairman of the Subcommittee on Health, announced on May 14 a hearing titled ‘Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms.’ The hearing is scheduled for May 20 at 2:00 PM ET in the Rayburn House Office Building.
According to Guthrie and Griffith, “As the Committee continues working to improve care for seniors, this hearing will examine efforts under the Medicare Access and CHIP Reauthorization Act (MACRA) to reform Medicare physician payment and explore current challenges in the Medicare physician fee schedule. Despite efforts in MACRA to move past annual ‘doc fixes’ and enhance seniors’ quality of care, we have continued to see physician payment instability in the Medicare program. This uncertainty, in addition to other regulatory burdens, creates challenges for providers and, ultimately, the beneficiaries they serve. This hearing will examine these long-standing challenges and help identify solutions to stabilize physician payment and protect seniors’ access to care.”
Dr. Rick Snyder, President of HeartPlace and an interventional cardiologist practicing in Texas, provided testimony before the subcommittee. According to Snyder’s statement included in the announcement: “The Medicare Physician Fee Schedule is not just an accounting formula. It is one of the most important forces shaping where patients receive care, what that care costs, and whether independent physicians can continue serving the people who rely on them. Right now, the system is completely broken. Hospitals receive automatic annual inflationary updates from Medicare. Physicians do not, even though the costs of operating a medical practice — staffing, rent, insurance, technology, and supplies — continue to rise dramatically.” Snyder said that after adjusting for inflation since 2001 there has been a 33% decline in Medicare physician reimbursement.
Snyder also said that this divergence between hospital payments and those received by independent practices is causing many independent practices to close or be acquired by hospitals: “Hospitals acquired nearly 33,000 physician practices and added more than 181,000 physicians to their employment rolls between 2018 and 2026… Today almost 60% are employed by hospitals.” He argued that this trend increases costs for both patients—who may pay higher out-of-pocket expenses—and taxpayers.
In his testimony Snyder advocated for reforms including a permanent inflation-based update tied to the Medicare Economic Index as well as site-neutral payment policies so that identical services are reimbursed at identical rates regardless of location.
The hearing will be open to both public attendance and press coverage with livestreaming available online at energycommerce.house.gov according to the organization’s press release.
