CMS' proposed rule for 2023 has been met with criticism from orthopedic surgeons, especially with its plans to decrease the Medicare Physician Fee Schedule.
Two orthopedic surgeons share what they want to see from the agency.
Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.
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Editor's note: Responses were lightly edited for clarity and length.
Question: What's the biggest change you want to see from the CMS 2023 proposal?
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): Enormous losses in the first half of 2022 are being widely published over the past couple of weeks. Our healthcare system is heavily burdened by short staffing, burnout, and hospital capacity concerns, many of which are pandemic related. Oh, and by the way — we are still living in the pandemic. Unfortunately, these stressors are compounded by pressures to achieve financial and volume targets amid historical inflation rates. The proposed decrease in the Medicare Physician Fee Schedule for 2023 may have negative consequences that will force providers to shoulder some of this financial burden and potentially limit critical access for Medicare patients; potentially marginalizing a population that is currently being further marginalized by larger macroeconomic forces. The Medicare Fee Payment Schedule needs to focus on targets around quality and cost-effective care, rewarding those focused on these results.
Morgan Lorio, MD. Advanced Orthopedics (Altamonte Springs, Fla.) and Chair of ISASS Coding and Reimbursement Task Force and ISASS RUC Advisor: CMS needs to accept the RVS Update Committee's recommendations as presented to them. These procedure values should be published as proposed in the Proposed Rule. CMS should consider data presented to them from interested parties and key stakeholders during the comment period and then make final rule decisions based on critical information collected during this time.