Congressional Update: Action Needed to Fix Medicare

We are asking NCMS members to contact their members Congress to urge passage of H.R. 2474.



The need for Congress to act quickly and decisively to fix a broken Medicare payment system cannot be overstated. The fiscal stability of physician practices and the long-term viability of our nation’s entire health care system hang in the balance.

The NC Medical Society has been engaged in the ongoing effort to reform the physician payment formula for many years, dating back to the national push to eliminate the antiquated Sustainable Growth Rate (SGR) which was in effect from 1997 until 2015.  When the SGR was replaced by MACRA, there was universal acknowledgement that the transition was an improvement but not a permanent solution to the dilemma that physicians face annually in trying to keep pace with the rising cost of serving the Medicare population.  NCMS efforts have included numerous trips to Capitol Hill, in-district meetings with our members of Congress, countless sign-on letters and calls, and a steadfast commitment to the collective effort among our partner organizations dedicated to Medicare reform.

The Society is presently working closely with our national and state partners to promote outreach to Congress, including the American Medical Association.  Medicare payment reform is the first pillar of the AMA’s Recovery Plan for America’s Physicians and the AMA has developed and shared numerous resources that are helping our effort.

North Carolina saw a 24.5% increase in Medicare beneficiary enrollment from 2013 through 2021 – from 1.7M to 2.1M.  The resulting access-to-care challenge that Medicare patients face will only get worse without reform of  the current payment system.

Relief from annual funding cuts is an immediate need, along with fundamental changes to Medicare reimbursement centered on simplicity, predictability, relevance and alignment, as outlined in recommended reform principles. The current Medicare physician system does not reflect those principles, which we are working to change.

The government’s Medicare Economic Index (MEI), which gauges the inflation in medical practice costs, will hit 4.5% in 2024, its highest level in two decades. When combined with the 3.8% hike in the MEI recorded in 2023, that means medical practice costs increases will have exceeded 8 percent over just two years. Many individual and group physician practices have experienced cost increases well beyond this level, while still seeking a full recovery from pandemic-related setbacks.  This dilemma has put patients ultimately in the crosshairs.

Adding to the pain, provisions in current law require the Centers for Medicare & Medicaid Services to implement a 2%, across-the-board reduction in Medicare physician payment rates this year, with another 3.36% cut to the conversion factor scheduled for 2024. In stark contrast to the annual payment increases tied to inflation given to hospitals, skilled nursing facilities and other entities that bill Medicare, physician practices do not qualify for automatic annual inflationary adjustments, requiring us to fight to reduce or delay payment cuts nearly every year.

Taking inflation into account, Medicare physician payment rates fell 26% from 2001 to 2023, while practice costs rose by 47% over the same period. We must place physician practices on sound financial ground through Congressional action to fix the Medicare physician payment system.


Legislative relief – An opportunity for you to get involved


The NC Medical Society joins the AMA and our many national specialty society partners in strongly supporting the Strengthening Medicare for Patients and Providers Act (H.R. 2474), a bipartisan measure now pending in the 118th Congress.  This legislation would provide the crucial link between the Medicare physician payment schedule and the MEI, and finally put physicians on an equal fiscal footing with other entities drawing Medicare payment.

We are asking NCMS members to contact their members Congress through this AMA portal to urge passage of H.R. 2474.

When you reach out to those who represent you, in addition to expressing concern, also ask for a meeting, either in person or virtual, during their August recess or later this year.  If you are able to set up a meeting, either with a House or Senate member or with one of their staff members, resources to help you are available at, including plain language explanations of the need for: automatic, annual inflation-based payment updates, reforms to budget neutrality policies, and simplifying the Merit-Based Incentive Payment System (MIPS). Every call and every meeting make a difference, especially when you share how the current Medicare payment system is impacting patients and your practice.

If you need help making a connection as a constituent, contact Alan Skipper, NCMS Vice President/External Affairs ([email protected]).

The North Carolina Medical Society will continue its fight for a financially stable and more predictable Medicare physician reimbursement model that protects your Medicare patients and you. We ask that you join us in urging Congress to ensure that Medicare continues to fulfill its crucial role in safeguarding both the health and financial well-being of tens of millions of Americans. Thanks for being an active advocate.