News & Resources

Physicians’ Voices Heard As CMS Brings Listening Road Trip To Dayton

Provided by MCMS Administration

A vocal group of local physicians from across specialties and practice models met with representatives from the Centers for Medicare and Medicaid Services (CMS) last week to share their stories and experiences concerning how these programs affect their ability to practice medicine.  Your MCMS and OSMA were able to secure a meeting with leaders from the CMS regional office who wanted to hear directly from physicians about how the rules and regulations of Medicare and Medicaid impact their patients and practice.  Specifically, the CMS team was interested in identifying points of intersection with the CMS goals of improving health equity, health disparities and social determinants of health.  Nearly forty physicians and office managers participated in this interactive, bilateral and productive discussion.

High on the list of concerns noted was the dwindling Medicare Physician Fee Schedule (PFS), which has annually and systematically reduced physician payment for nearly 30 years.  What’s more, average payment rates under the PFS are proposed to be reduced by 2.93% in 2025, and physicians are the only sector in health care suffering from these discriminatory cuts.  These cuts have resulted in an increasing number of independent physicians closing or selling their practices, opting to become employed, or retiring altogether.  This has been a significant contributor to shortages of physicians in high-need specialties and geographic areas, especially in primary care.  

Additionally, there were numerous comments and stories shared regarding the challenges presented by the Medicare Managed Care programs (Medicare “Advantage”).  Automatic denials and down-coding without meaningful chart review must stop.  Clearer guidance and more resources are required for necessary hospice and palliative care.  Prior authorization requirements serve only to delay necessary care, increase physician practice costs and cause patients harm.  Delays in approving necessary surgical procedures have left OR schedules in a quagmire of uncertainty.  Additional full-time employees are needed to handle the business of tracking and appealing claims denials.  Documentation and charting requirements often require more face time with a computer than with the patient. All of these issues lead to increases in health care costs, physician frustration and patient harm.

Our guests from CMS were extremely receptive to our concerns, and assured us of meaningful follow-up and ongoing bilateral communication. 

OPEN COMMENT PERIOD

The CMS representatives advised that the public comment period for Calendar year 2025 Medicare and Medicaid proposed payment policies is open until September 9, 2024. They suggest all physicians offer your comments detailing how payment cuts will detract from your ability to provide quality patient care. Especially include statements that will support how your concerns will negatively impact health equity, access and social determinants of health. The more comments that support a given topic can elicit responsive attention to your concerns, so encourage all of your physician colleagues to comment as well!  You may offer your comments here.

MCMS FOLLOW-UP

These CMS representatives offered to return to Dayton to speak again in person with our local physicians. MCMS is interested in planning another session early next year. If you missed this opportunity to engage in this important dialogue, please watch for future notices and plan to attend. If you have questions or concerns, reach out to our office (937-223-0990, mcmsoh@gmail.com) and we will put you in contact with these regional representatives.

This unique and unprecedented opportunity to meet with officials from CMS represents just one of many MCMS advocacy efforts on behalf of our physician members.  Please renew your 2025 membership as soon as possible.  If you are not already a member, a special introductory rate can be found here.  MCMS serves as the unified voice for our local physicians, and that voice has never been stronger!