on October 31st letter To Congress, the California Medical Association (CMA) detailed its recommendations for stabilizing the Medicare payment system in response to Congress’ request for stakeholder input.
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these are Recommendation Stopping payment cuts and implementing annual inflation updates, reducing incentives that have caused provider consolidation and rising health care costs, reducing administrative burdens, and any alternative payments to allow more doctors to participate Includes model approval.
The CMA also addresses the gap between Medicare payments and geographic costs of care and recommends adopting a successful value-based model of care.
Donaldo Hernandez, MD, president of CMA, told State of Reform that unsustainable Medicare physician tariffs undermine physicians’ ability to participate in value-based care models and reduce patient access to care. He said he was threatening me.
“It has long been a challenge for doctors to be able to afford to see patients on Medicare,” said Hernandez. “We are now dealing with a post-pandemic world. Many healthcare workers are leaving their jobs.
On the caregiving side, mass retirement is happening, and inflation, coupled with the actual cost of providing care in the office, means that Medicare doesn’t cover that cost, so you’re going to lose money. It becomes a matter of affordability to see these patients who want to. ”
About 50% of the California clinic patient population is covered by Medicare, according to the CMA. The association emphasized the importance of Medicare in all other health care payment systems, as the Medicare tariff is what determines the payout rate for all individual payers.
Hernandez said nearly 76% of doctors reported that their Medicare payments could no longer cover the cost of providing care, and many doctors left the practice due to retirement or pandemic-related issues. Because of this, many Medicare patients who have been in clinics and doctors across the state are no longer accepting new Medicare patients and can no longer find medical facilities to be found in community settings.
“We want to take care of those patients, but we can’t do it at the expense of the anxiety of being able to maintain their practice.” but it’s also important that we don’t continue to experience this annual reduction risk, we keep fighting and trying to stay at zero but it’s an ongoing challenge and issues remain .”
Stabilizing Medicare payments and investing in appropriate levels of payments will ensure an adequate supply of doctors in the Medicare program and reduce overall health care costs, the CMA says. In a letter to Congress, the CMA said that when doctors leave the Medicare program, patients are forced to seek emergency room care or be hospitalized when their condition worsens, increasing Medicare program costs. I warn you that it will increase.
