CMS Expands Access to High-Quality Care With Physician Payment Rule Proposal

August 10, 2022 by Alec Stone MA, MPA, ONS Government Affairs Director

To decrease cost and increase access to care, in July 2022 the Centers for Medicare and Medicaid Services (CMS) proposed (https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-proposed-rule) a conversion factor of $33.08 for the 2023 Physician Fee Schedule (PFS).

The proposed (https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-proposed-rule) rule would be a notable decrease from the 2022 PFS conversion factor of $34.61, but it could greatly expand (https://www.cms.gov/newsroom/press-releases/cms-proposes-physician-payment-rule-expand-access-high-quality-care) patient access to behavioral health services, Accountable Care Organizations, cancer screening, and dental care, especially for those in rural and underrepresented areas. CMS said it hopes (https://www.cms.gov/newsroom/press-releases/cms-proposes-physician-payment-rule-expand-access-high-quality-care) its actions will continue its work in “advancing health equity; driving high-quality, whole-person care; and ensuring the sustainability of the Medicare program for future generations.”

“Integrated coordinated, whole-person care—which addresses physical health, behavioral health, and social determinants of health—is crucial for people with Medicare, especially those with complex needs,” Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare, said (https://www.cms.gov/newsroom/press-releases/cms-proposes-physician-payment-rule-expand-access-high-quality-care). “If finalized, the proposals in this rule will advance equity, lead to better care, support healthier populations, and drive smarter spending of the Medicare dollar.”

The 2023 change could help address a number of healthcare issues outlined in the Biden-Harris administration’s Unity Agenda, including cancer research and treatment. Advocating for widened access to health care (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer) can help ensure that underserved populations (https://voice.ons.org/news-and-views/quality-cancer-care-includes-recognizing-underrepresented-patients) and other patients with cancer receive the care they deserve.


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