LUGPA Champions Medicare Payment Reform Following Latest CMS Proposal

CMS and Congress Must Address Unsustainable Trend of Physician Payment Cuts to Protect Patient Access to Quality Care

Chicago, IL, July 18, 2024 – LUGPA, the national voice representing independent urology in the United States, expresses deep concern over the Centers for Medicare and Medicaid Services' (CMS) recent proposal to reduce physician reimbursements as part of the 2025 Medicare Physician Fee Schedule (MPFS). This proposal forebodes another significant cut that threatens the financial viability of independent practices and patient access to care.

The proposed 2025 conversion factor of $32.36 represents a 2.8% decrease from 2024.This component of the MPFS is constrained by the legal requirement for Medicare programs to maintain budget neutrality, which means any increase in reimbursement for one service necessitates a decrease for another. LUGPA, alongside other leading physician groups nationwide, has long advocated for an overhaul of this policy because it fails to account for inflation and the rising costs of providing medical care.

With 92% of medical groups reporting increased operating costs, the proposed cuts are alarmingly shortsighted. From the 2020 schedule to the proposed 2025 schedule, the MPFS conversion factor has decreased by about 10.33%, while average inflation has increased costs by approximately 20%.

“These continuous cuts to physician reimbursement are unsustainable,” said Evan R. Goldfischer, M.D., LUGPA President. “The ongoing and cumulative pay cuts are eroding the foundation of independent practice. Physicians who are small business owners are increasingly driven towards early retirement or employment by large hospital systems. Under the guise of budget neutrality, CMS has perpetuated this detrimental trend, resulting in increased consolidation and higher health care costs.”

LUGPA has consistently urged Congress to implement stable payment updates that accurately reflect the costs of health care practice. LUGPA’s Health Policy and Political Advocacy teams will work with other stakeholders to create a unified front, engaging lawmakers to push for legislative adjustments to ensure fair compensation.

“Real progress requires CMS and Congress to take definitive action on physician payment reform,” said Mara Holton, M.D., LUGPA Board Member. “Creative solutions are urgently needed to truly reward high-value health care—both preventative and procedural. Unless CMS and Congress act on the crucial need for systemic reform, the long-term consequence will be a decrease in patient access to care.”

In response to the proposed rule, LUGPA will collaborate with policy experts and aligned stakeholders over the coming weeks and months to develop and submit comprehensive commentary to CMS. LUGPA members will also meet directly with lawmakers in Washington, D.C., to advocate for reforming how Medicare reimburses physicians.

LUGPA will continue to promote member awareness and involvement through online and in-person events and ongoing public messaging, highlighting the impending impact on patient care. Stay up to date on LUGPA’s health policy and advocacy efforts at www.lugpa.org/policy-advocacy.