November 10, 2023 Congresswoman Barbara Lee 2470 Rayburn HOB Washington, D.C. 20515 Dear Congresswoman Lee: I am writing on behalf of the Alameda-Contra Costa Medical Association (ACCMA) – representing 5,500 physician members – to urge you to stop the 3.4% Medicare physician payment cut scheduled for January 1, 2024, which comes on top of the 2% payment cut we experienced in 2023. These cuts will have a devastating impact on physician practices and patient access to medical care. The Centers for Medicare and Medicaid Services (CMS) just released the final Medicare Physician Fee Schedule that includes a 3.4% payment cut that will take effect if Congress does not act. Physicians are the only Medicare providers who do not receive an automatic annual inflationary update which means we will not receive a 4.5% inflationary update in 2024 like all other health care providers (i.e., hospitals, nursing homes). In fact, since 2001, Medicare physician payments fell 26% while practice costs rose 47%. California physicians are sounding the alarm – patient access to care in Medicare is deteriorating because the Medicare physician fee schedule has remained stagnant for nearly two decades. Physicians continue to experience burnout. They are overwhelmed with sicker patients who suffer due to delayed care and mental health issues from the pandemic. Wages that physicians must pay their nurses and staff are skyrocketing. Yet, despite this mountain of need, Medicare is providing fewer resources to help physicians. In a recent CMA survey, nearly half the physicians reported that they plan to retire early and 3040% said they are dropping out of Medicare or closing their practices to NEW patients. These physician shortages are causing longer wait times for patients to see a physician. Emergency rooms cannot attract enough specialists to care for patients in emergencies. In several urban areas across California, no primary care physicians are accepting NEW Medicare patients. In California’s rural and underserved communities, the access challenges are dire. California is projected to have the largest physician shortage in the nation because of our growing and aging population, our aging physicians, and the inadequate Medicare payments which also influence all private health plan payments. Congress must immediately begin the work of long-overdue Medicare physician payment reform that will lead to the program stability that beneficiaries and physicians need. ACCMA physicians have expressed their immense disappointment over the previous Medicare payment cuts. Some of their reactions have included the following: • “If the federal government wants to decrease the number of practicing physicians, this is the way to do it. I fear for patients...as their doctors leave practice earlier than they had
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planned, due to the never-ending increases in paperwork, pointless regulations, denials, authorizations, and on and on and the never-ending decreases in reimbursement.” “I have been a provider for Medicare for 43 years. Is this my reward? A decrease in payment at the time of inflation?” “With rising costs and declining Medicare reimbursement rates, my physician colleagues and I, who serve our community, are forced to choose between rebalancing our patient group to reduce Medicare enrollees or ultimately risking the viability of our practices.” “I worry more about our Medicare seniors/retirees and their ability to secure good healthcare.”
We ask you to stop the 3.4% payment cut or provide an inflationary update for 2024 to stabilize physician practices, protect patients, and meet the promise of Medicare for our state’s seniors. We thank you for your support of California physicians and we look forward to our continued collaboration to improve healthcare access for our patients. If you have any questions, please do not hesitate to contact Mr. David Lopez, ACCMA Director of Advocacy and Governance, at dlopez@accma.org or (510) 654-5383. Sincerely,
Albert L. Brooks, MD ACCMA President