PEPC Op-Ed: Updated Clinician Pricing is a Matter of Survival for Small Practices

To give independent practices and physicians a chance to remain independent if they choose to, reimbursement structures for federal programs such as Medicare must keep pace. This is true even as organizations like the Partnership to Empower Physician-Led Care advocate for value-based care models as a path to sustainability for independent practices. Many value-based care models are built off the fee-for-service chassis; as a result, it is imperative that the chassis appropriately compensate physicians for the clinical value of their services.


We cannot realize the vision for our health care system without ensuring appropriate payment as the underlying foundation. Despite rising costs and inflation, until recent proposals by CMS, Medicare clinical labor pricing had not been updated for almost 20 years. As a result, the services of doctors, nurses and other skilled clinicians was systematically undervalued by the Medicare program, with the gap between actual costs and reimbursed costs widening over time as costs increased.

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