Medical groups say Medicare payments won’t cover the cost of delivering care

October 20, 2021 – A recent Medical Group Management Association (MGMA) Stat poll revealed that nearly three-quarters (73%) of medical practices report that 2021 Medicare payments will not cover the cost of delivering care to beneficiaries.

That figure represents an alarming trend, wrote Claire Ernst, JD, for a MGMA blog. A similar MGMA Stat poll in 2019 found more than two out of three (67%) medical practices reported Medicare payments did not cover the cost of delivering care.

The poll was conducted Oct. 12, 2021, and had 347 applicable responses.

“The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) intended to stabilize physician payment rates in Medicare’s fee-for-service (FFS) system and incentivize physicians to move into value-based payment models,” Ernst wrote. “However, the well-intentioned program resulted in burdensome and costly reporting requirements and has not provided adequate alternative payment model (APM) participation options as originally envisioned. Additionally, under MACRA’s revised methodology for updating the physician fee schedule (PFS), Medicare FFS payments are not keeping up with inflation or the cost of running a medical practice.”

Unfortunately, as we head toward CY 2022, physician practices are facing a handful of potential Medicare financial hits, stemming in part from Medicare budget neutrality requirements, Ernst wrote.

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