Don’t Cut Pay for Frontline Healthcare Providers

As a physician, it is my duty to provide care to every patient that comes my way. But the delicate balance in our healthcare system that allows doctors to provide care to all patients, particularly the most vulnerable, grows more fragile every year. This year, patient care is under threat once again thanks to another planned cut in Medicare payments to doctors. Even in the best of times, doctors are often asked to do more with less. After years of financial strain and burnout, any additional cuts from Medicare will certainly worsen the shortage of our hospital-based physicians needed to maintain our healthcare safety net. 

Most patients might not know about the mechanism through which coverage for medical care is determined for those who qualify for Medicare and for the uninsured. Each year, the Centers for Medicare & Medicaid Services (CMS) uses the Medicare Physician Fee Schedule (MPFS) to determine the rate at which each specialty will be reimbursed for services provided.  

As healthcare costs and inflation continue to rise, you might assume that CMS would provide more resources to help cover these increasing costs. However, this is not the case. Physician payments have declined 26% from 2001 to 2023, even after adjusting for inflation, and CMS recently announced another net reduction across all specialties set to begin in January 2024. 

These proposed cuts are extremely worrisome, and, if enacted, will have widespread and devastating consequences for both patients and physicians. Medicare cuts will be especially disastrous for emergency departments, which are the nation’s critically needed safety net for uninsured individuals. If emergency departments begin to close across the country due to lack of funding, millions of patients in local communities will be left without the ability to receive care. 

Medicare reimbursement cuts are not the only factor placing intense financial burden on America’s healthcare system. Physicians continue to fight aggressive insurance companies who delay payments, flat-out refuse to compensate for care, or insist on comically low reimbursement levels. In the last few years, providers, including TeamHealth, have won multiple lawsuits against large insurance companies who refused to pay doctors fairly for lifesaving care. These lawsuits are just the tip of the iceberg and compound the financial pressure that doctors face by holding final payments up in the court systems for sometimes years.

It often seems as though healthcare professionals are under attack from all sides. Since the pandemic, clinician burnout rates are at historic levels and violence against healthcare professionals continues to rise. All the while, healthcare systems are fighting Medicare every year to ensure enough funding to keep operations running. As an emergency physician, I understand that one day I will need to access the very system in which I work. Watching the system deteriorate due to underfunding by both government and commercial payers has me worried about the quality of care my own family, as well as every American family, may soon face.   

Increasing Medicare reimbursement rates to a sustainable number is the only way to ensure that physicians can continue providing lifesaving care to patients. Congress must step in to address this upcoming cut in Medicare reimbursement before it is implemented. At the same time, CMS should be doing everything in its power to mitigate the need for further cuts, recognizing that patients can only receive care if doctors and hospitals are able to provide it. 

On behalf of our most vulnerable patients and the physicians who serve them, I urge policymakers in Washington, D.C., to stop these reimbursement cuts and provide stability, reassurance, and predictability to our healthcare system before irreversible damage is done to patients and physicians across the country.

Jody Crane, MD, MBA, is the Chief Medical Officer for TeamHealth.