The 2024 Medicare Physician Fee Schedule Final Rule has been released and sparked a variety of responses in its wake. Although elements, for example telehealth and value-based care, are being applauded, providers express objections over a 1.25% overall payment reduction compared to 2023.

Another point of contention is the finalized conversion factor of $34.74, signaling a 3.4% decrease from 2023. Dr. Jesse M. Ehrenfeld, President of the American Medical Association, communicated her disappointment, emphasizing that this reduction compounds the financial strain on both patients and physicians. The 4.6% Medicare Economic Index (MEI) increase further exacerbates the challenge, according to Ehrenfeld, questioning the sustainability of Medicare for practitioners.

Provider groups, including the Medical Group Management Association (MGMA) and America’s Physician Group (APG), are urging Congress to address these cuts. SVP of Government Affairs at MGMA, Angers Gilberg, points out the widening gap between practice expenses and reimbursement rates. On the other hand, APG’s President and CEO, Susan Dentzer, warns of the potential impact on physician retention.

Despite financial concerns within the final rule, there are also notable victories. • Telehealth policies are extended through 2024. This allows physicians to list their practice address and reimburse home-based telehealth services at higher rates. • The 2024-Merit-Based Incentive Payment Systems (MIPS) performance threshold will remain at 75 points, alleviating fears of a substantial increase. • The final rule aims to advance value-based care, with changes to financial benchmarking methodologies benefiting Accountable Care Organizations (ACOs) serving a variety of populations.

Acknowledging the positive steps within the final rule, the National Association of Accountable Care Organizations (NAACOS) has expressed disappointment that certain policies will only apply to new or renewing ACOs in 2024.

The 2024 final rule introduces various coding and payment changes. These changes specifically support primary care, health equity, and access to behavioral and oral healthcare. In particular, it allows for marriage and family therapists and mental health counselors to enroll in Medicare for the first time. However, despite the positive direction, Premier points out the paused efforts of the Appropriate Use Criteria (AUC) program, warning of its potential effect on innovation.

The 2024 Medicare Physician Fee Schedule Final Rule reflects a delicate balance between financial constraints and advancements in telehealth, value-based care, and additional support services. Providers are urged to take proactive measures in navigating these challenges. A score of 75 or greater will only be achieved through improvement, valuable feedback, and support. Working with a MIPS qualified registry can help to navigate the complexities of an evolving healthcare landscape while adding value to your practice.