The 3 Policies Controlling Physician Reimbursements


Three big CMS moves have affected physician reimbursements in the last 10 years, according to VMG Health’s 2023 mergers and acquisitions report released on March 21:

Here are the three CMS policies:

  1. In April 2015, the Senate passed the Medicare Access and CHIP Reauthorization Act, which permanently removed the sustainable growth rate formula under the medicare payment system, replacing it with a fixed .5 percent annual increase through 2019.
  2. Under MACRA, after 2019, physician payments were set to remain flat until 2025. During this time period, individual physicians can receive payment increases through the merit-based incentive program.
  3. In November, CMS released the Medicare final rule payment and policy change final rule. The rule kept a 2 percent Medicare reimbursement cut to physicians in 2023, and 2024 may bring at least another 1.25 percent cut.

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