Emergency physicians provide the vast majority of acute care for Medicare and Medicaid patients in the U.S. Medicare rates are often used to set Medicaid and private payor payment rates, yet they do not cover the costs of providing care and have not kept up with the pace of inflation over the last few decades. However, inadequate Medicare and Medicaid payment rates ultimately damper the medical student pipeline and make it more challenging for patients seeking emergency care.
Given the importance of Medicare payment policies on emergency physician reimbursement, ACEP has advocated to both the Centers for Medicare & Medicaid Services (CMS) and to Congress to address the payment deficiencies in Medicare and impose payment rates that increase with inflation.
The annual Medicare Physician Fee Schedule (PFS) regulation makes updates not only to Medicare physician payments for the next calendar year, but also to the Quality Payment Program (QPP), the major quality reporting program for physicians under Medicare. Failure to successfully participate in the Merit-based Incentive Program (MIPS)—the main track within the QPP—could result in a 9 percent reduction to your Medicare payments.
In addition, ACEP works with other influential nongovernmental organizations to advocate for important issues affecting emergency physicians.