关于改革医生支付系统和保护远程医疗服务的无党派提案
Laxmaiah Manchikanti1, Paul J Hubbell Iii2, Ramarao Pasupuleti3
1Pain Management Centers of America, Paducah, KY; Departments of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Department of Anesthesiology, School of Medicine, LSU Health Science Center, New Orleans, LA.
Pain physician
|August 7, 2025
概括
医生支付削减威胁到医疗保健的准入,尽管最近的一项法案提供了一个小的医疗保险医生费用表更新. 扣留和其他减少继续,影响医生可持续性和患者护理.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医疗政策 医疗政策
- 医生补偿医生补偿金
背景情况:
- 自2001年以来,由于通货膨胀和封存削减,医疗保险医生付款下降了33%.
- 年度封存削减,持续到2032年,复合支付削减.
- 保险费的上和医生补偿的停滞之间存在差异.
研究的目的:
- 分析最近立法行动对医生支付的影响.
- 突出医生面临的财务挑战.
- 检查拟议的医疗保险优势计划的增加,而不是医生支付的削减.
主要方法:
- 审查有关医疗保险医生支付的立法行动.
- 对医疗保险和医疗补助服务中心 (CMS) 支付建议的分析.
- 审查美国干预性疼痛医生协会 (ASIPP) 改革提案.
主要成果:
- 一项和解法案 ("大美丽法案") 为医疗保险医生费用计划提供了89亿美元的投资,并为2026年更新了2.25%的费用.
- 该法案未能解决预算中立性,实践成本,通货膨胀,封存或MACRA/MIPS问题.
- CMS完成了2.8%的医生支付削减,并取消了远程医疗服务.
结论:
- 持续的医生薪酬削减威胁到提供者的可持续性和患者获得护理的机会.
- "大美丽法案"提供了不足的救济,也未能解决严重的财政压力.
- 消除远程医疗服务进一步加剧了访问问题.
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