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LACMA Addressing the Impact of Medicare Cuts


The Los Angeles County Medical Association (LACMA), representing nearly 7,000 physicians and medical students, has recently raised an urgent issue affecting the healthcare system in California. LACMA has penned a letter to the members of the Los Angeles County Congressional delegation, highlighting a critical concern: the impending 3.4% Medicare physician payment cut scheduled for January 1, 2024. This article aims to dissect this issue and its implications, particularly for the physician community.


The looming cuts have tangible, alarming ramifications for patient care. A California Medical Association (CMA) survey revealed that nearly half of the responding physicians are considering early retirement, and up to 40% are thinking about withdrawing from Medicare or ceasing to accept new patients. This scenario leads to longer wait times for appointments and a shortage of specialists, particularly in emergency rooms and in areas where no primary care physicians are accepting new Medicare patients. The impact is even more severe in rural and underserved regions.


California is projected to face the nation's largest physician shortage, exacerbated by a growing and aging population. The cuts to Medicare payments could undermine care for seniors and influence private health plan payments, setting a concerning precedent.


We urged our members of the California delegation to intervene and prevent the 3.4% payment cut or advocate for an inflationary adjustment for 2024. This action is crucial to stabilize physician practices, safeguard patient care, and uphold the Medicare promise for California's seniors.


November 10, 2023


Congresswoman Linda Sanchez

2428 Rayburn House Office Building

Washington, DC 20515


Subject: Urgent Request to Halt the Medicare Physician Payment Cut


Dear Congresswoman Sanchez,


I am writing to you as the CEO of the Los Angeles County Medical Association

(LACMA), representing nearly 7,000 physicians and medical student

members of LACMA, as well as the millions of Californians they serve. We are

at a critical juncture where the welfare of our healthcare system and patient

access to care are at risk due to the impending 3.4% Medicare physician

payment cut scheduled for January 1, 2024.


This reduction follows a 2% cut already implemented in 2023 and poses a

significant threat to the sustainability of physician practices across California.

It is distressing to observe that while the Centers for Medicare and Medicaid

Services (CMS) has issued a final Medicare Physician Fee Schedule that

includes this detrimental cut, physicians remain the only Medicare providers

not receiving an annual inflation update. The absence of a 4.5% inflation

adjustment in 2024, which other healthcare providers will benefit from, only

exacerbates the strain on our healthcare infrastructure.


Since 2001, we have witnessed a 26% decrease in Medicare physician

payments, juxtaposed with a 47% increase in the cost of maintaining a

medical practice. This divergence has led to a perilous tipping point:

physicians are increasingly facing burnout, managing higher volumes of

patients with complex health issues, including the long-term effects of the

pandemic, all while compensating their dedicated staff amid rising wages.

The ramifications are tangible and alarming. A recent California Medical

Association (CMA) survey revealed that nearly half of the responding

physicians are considering early retirement, while up to 40% are

contemplating withdrawing from Medicare or ceasing to accept new

patients. This exodus is resulting in protracted wait times for appointments

and a scarcity of specialists in emergency rooms, particularly in urban areas

where no primary care physicians are accepting new Medicare patients.

Moreover, in California’s rural and underserved regions, the situation is even

more dire, exacerbating the existing challenges in accessing care.

As the state is projected to face the nation's largest physician shortage,

exacerbated by our growing and aging population, the cuts to Medicare

payments not only undermine the care for our seniors but also set a

concerning precedent influencing private health plan payments.


We implore you, as a respected member of our California delegation, to

intervene and prevent the 3.4% payment cut or alternatively, to advocate for

an inflationary adjustment for 2024. Such decisive action is paramount to

stabilizing physician practices, safeguarding patient care, and upholding the

Medicare promise for California's seniors.

We are grateful for your enduring support of California physicians and trust

that you will consider this plea with the urgency and gravity it warrants.

Sincerely,


Gustavo Friederichsen

CEO, Los Angeles County Medical Association



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