CMS' proposed cuts to physician fees focus on the operating room. For the primary care physicians managing recovery after surgery, the real gap is much larger.
Health care was the only one of five sectors to cut spending commitments this spring, falling 2.8% as hospitals faced rising supply costs and physicians awaited the final 2027 Medicare fee schedule, Coupa's Business Spend Index found.
Medical Economics spoke with MGMA's Madison Hynes about the association's draft bill to ban automatic downcoding, the Patients First Act and AI-run prior authorization in traditional Medicare.
EBRI data show employer plans pay hospital outpatient departments about twice what physician offices receive for the same physician-administered drugs, and the commercial market has barely begun to address the gap.
A simple break-even calculation turns a reimbursement advantage into staff minutes, showing practices when prior authorization, denials and uncollected patient balances wipe out a better rate.