A significant factor driving consolidation in the health care industry is declining physician reimbursement, particularly declining Medicare payments to surgeons. Not only have Medicare payments to joint replacement surgeons dropped 65% in the last 30 years, adjusted for inflation, but in 2024 surgeons must plan for yet another scheduled Medicare cut of 3.3%, the expiration of the 5% Alternative Payment Model (APM) Incentive Payment, the ongoing 2% sequestration reduction and the imminent expiration of the geographic practice cost index floor.

Persistent and continuing cuts in Medicare payments in the face of rising practice costs impair the ability of surgeons to successfully run any of the spectrum of practices models. Less funding for surgeons leads to less access to necessary care, longer wait times for procedures, and challenges to maintaining quality of care.

Real, stable, and permanent reform of Medicare physician payment must ensure that reimbursement (1) grows with inflation, (2) grows commensurate with facility payments, and (3) does not pit medical specialties against each other.  A good first step is for Congress to enact H.R. 2474, the Strengthening Medicare Patients and Providers Act.