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ASCRS and Medical Community Call on Congress to Increase Medicare Physician Payment Update Factor, Extend Advanced APM Bonus, and Enact Other MACRA Legislative Reforms

ASCRS is joining with the medical community in a letter to Congressional leadership requesting legislative changes to the MACRA statute to increase the annual Medicare physician update factor and extend the 5% bonus physicians receive for participating in advanced alternative payment models (APMs).

As we have reported, the MACRA statute included five years of positive 0.5% payment updates from 2015–2019. However, it reduced the update factor to 0.0% for 2020–2026 and then specified in subsequent years payment updates of 0.75% and 0.25% for physicians participating in advanced APMs or MIPS, respectively. In the letter, we note that a recent Medicare Trustees report found that Medicare physician payments are not keeping pace with inflation, and we request that Congress increase payment updates to a level that better reflects the costs of providing care to Medicare beneficiaries.

Regarding the advanced APM bonus, the letter highlights the current lack of available models, which has prevented many physicians from joining APMs and thereby receiving the 5% bonus available for the first six years of the program. We recommend Congress extend the bonus for an additional six years to allow more time for new models to be developed and physicians to implement them.

Finally, the letter includes other recommended statutory changes to MACRA aimed at simplifying and streamlining the program. We ask Congress to provide explicit statutory flexibility to award MIPS participants multi-category credit for certain activities; remove the requirement that the MIPS threshold be set at the mean or median of previous years’ scores and give CMS the authority to set the threshold at a level it deems appropriate; provide CMS with the authority to establish multiple MIPS performance thresholds, such as different levels for small and rural practices; and modify the Cost category to remove flawed population-based measures. We will keep you updated.

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