Fix the broken Medicare physician payment system that threatens patient access  

America’s physicians have more than stepped up to the challenges that they have encountered over the past three years. Throughout the pandemic, they put in countless hours, often risking their own health and safety to keep our communities healthier and safer.  

Even now, physicians nationwide continue to face grueling hours, rising costs, and widespread burnout that is undermining our nation’s health care workforce and could soon threaten patient access and affordability. What’s more, many physicians today are working under an unsustainable Medicare payment system that fails to adequately reimburse them for the critical, life-saving services they provide.  

When adjusted for inflation, Medicare physician payments declined by 26 percent from 2001 to 2023. Meanwhile, payments for other health care providers — including skilled nursing facilities as well as both inpatient and outpatient hospitals — have kept pace with inflation rates. In fact, physicians were the only provider group that did not receive a payment update in 2023 — all because the broken Medicare Physician Fee Schedule issued by the Centers for Medicare and Medicaid Services (CMS) consistently fails to include an annual inflationary update. With a severe shortage of physicians already impacting the United States, the declining reimbursement and rapidly rising costs will push more doctors out of the profession — especially in rural and underserved areas — at a time when we need more.  

Until policy changes are enacted to address the growing chasm between Medicare reimbursement rates for physicians and the real costs of running a practice, the challenges facing America’s physicians will only worsen. Ultimately, the consequences will undermine patient access to care, accelerate provider consolidation, and intensify the physician and health care workforce shortage that is already threatening many communities.  

That is why, as both lawmakers and physicians ourselves, we were proud to introduce the bipartisan Strengthening Medicare for Patients and Providers Act (H.R. 2474), legislation that would modernize the outdated Medicare physician payment system while protecting patients’ timely access to care. If passed, this bill would apply a permanent, inflation-based update to the Medicare Physician Fee Schedule, meaning Medicare reimbursements to physicians would more accurately reflect the real-world impact of inflation on the costs to physician practices.  

This long-overdue change would not only help provide greater stability within the Medicare payment system, but it would also help physicians’ practices — many of whom operate as small business owners — more effectively navigate the ever-changing economic factors that impact their practices, including rising medical costs, workforce and labor challenges, administrative burdens, office rental prices and more.  

In addition to failing to keep up with the true cost of providing care in today’s challenging economic environment, the Medicare Physician Fee Schedule has faced cuts year after year. It is our hope that by passing H.R. 2474, Congress can help put the Medicare physician payment system on a more sustainable path for the future, ensuring America’s physicians are reimbursed fairly and accurately.  

As physicians, each of us understands how the deeply flawed Medicare Physician Fee Schedule can undermine efforts to provide high-quality, affordable health care for patients. Since the pandemic, the administrative, financial and workforce challenges facing America’s doctors have grown exponentially. Urgent action by Congress is needed in order to address these concerns and ensure physicians across the country have the support they need to continue serving our communities.  

Passing the Strengthening Medicare for Patients and Providers Act would go a long way toward reforming the dysfunctional, unsustainable Medicare Physician Fee Schedule. Most importantly, it would help ensure fairness, provide financial stability for physicians, and protect vital access to care for millions of patients nationwide. We urge our colleagues to help us pass this much-needed legislation. 

Larry Bucshon, M.D., represents the 8th District of Indiana, Ami Bera, M.D., represents the 6th District of California, Raul Ruiz, M.D., represents the 25th District of California and Mariannette Miller-Meeks, M.D., represents the 2nd District of Iowa.