The American Alliance of Orthopaedic Executives is urging Congress to reform the Medicare payment system established under the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015, warning that a decade of inadequate updates has left orthopedic and musculoskeletal practices financially strained.
In a May 19 letter shared with Becker’s and submitted to the House Energy and Commerce Subcommittee on Health ahead of a hearing on the Medicare physician fee schedule, the AAOE, which represents more than 1,300 members across 660 practices, outlined four reform priorities and highlighted specific challenges facing musculoskeletal specialties.
Five things to know:
- Medicare physician payment has fallen 33% on an inflation-adjusted basis between 2001 and 2025, while staffing, supply and technology costs have continued to climb.
- Merit-based incentive payment system compliance costs average about $12,800 per physician annually and consume about 53 hours of physician time each year.
- Orthopedics and other procedural specialties are disadvantaged under MIPS because fewer relevant measures are available to them, which can lower performance scores.
- The group is calling for an annual inflationary update tied to the Medicare Economic Index, elimination of the 2% Medicare sequestration, reduced administrative burden under MIPS and opposition to mandatory alternative payment models.
- The AAOE supports the broader shift from MIPS to alternative payment models but said any models should be physician-led, voluntary and paired with financial incentives, including an extension of the APM participation bonus.
The letter was signed by AAOE president Terry Rosenthal and advocacy council chair Chris Roy.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
