Neurosurgeons Endorse Legislation to Improve Medicare Physician Payment System

The American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) applauded Reps. Raul Ruiz, MD, (D-Calif.); Larry Bucshon, MD, (R-Ind.); Ami Bera, MD, (D-Calif.) and Mariannette Miller-Meeks, MD, (R-Iowa) for their leadership in introducing H.R. 2474, the Strengthening Medicare for Patients and Providers Act. Introduced on April 3, the bill would put in place an annual physician payment update starting in 2024 based on the Medicare economic index (MEI), which reflects physician practice cost inflation.

The Medicare physician payment system is on an unsustainable path that has failed to keep up with inflation over the years, threatening patient access to care. When adjusted for inflation, Medicare payments to physicians declined 26% from 2001 to 2023. At the same time, the costs of running a medical practice increased by more than 70%, as measured by the Consumer Price Index, and nearly 50%, based on the MEI. By comparison, hospital updates totaled more than 60%.

The recently released Medicare Trustees Report highlighted the problems with the payment system, noting the annual payment updates are not expected to keep pace with the rate of physician practice cost increases jeopardizing access to care. The proposed legislation would, therefore, help ensure financial stability and predictability for physician practices, thus safeguarding access to high-quality, value-based care.

“Medicare physician payments have failed to keep pace with inflation, jeopardizing the viability of physician practices and patients’ timely access to care,” said Russell R. Lonser, MD, FAANS, chair of the Department of Neurosurgery at The Ohio State University and chair of the AANS/CNS Washington Committee. “While we are grateful that Congress has stepped in to mitigate steep Medicare cuts over the past few years, comprehensive reform of the physician payment system must be a priority for Congress this year.”

Last year, the neurosurgical groups endorsed principles for reforming the Medicare physician payment system, which includes a unified set of shared goals for improving the current system. AANS and CNS members have also identified this as a top legislative priority for 2023.

Dr. Lonser concluded, “Neurosurgeons take care of some of the sickest patients with brain tumors, degenerative spine disease, stroke and traumatic brain and spinal injuries. We agree with the Medicare trustees that access to Medicare-participating physicians will become a significant issue in the long term unless Congress takes steps to fix the payment system today.”

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The American Association of Neurological Surgeons, founded in 1931, and the Congress of Neurological Surgeons, founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals worldwide. These groups represent over 12,000 neurosurgeons worldwide. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves. For more information, please visit www.neurosurgery.org.