Congressman Brett Guthrie, Chairman of the House Committee on Energy and Commerce, and Congressman Morgan Griffith, Chairman of the Subcommittee on Health, announced on May 14 a hearing titled ‘Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms.’ The hearing is scheduled for Wednesday, May 20 at 2:00 PM ET in Room 2123 of the Rayburn House Office Building.
According to Guthrie and Griffith, “As the Committee continues working to improve care for seniors, this hearing will examine efforts under the Medicare Access and CHIP Reauthorization Act (MACRA) to reform Medicare physician payment and explore current challenges in the Medicare physician fee schedule. Despite efforts in MACRA to move past annual ‘doc fixes’ and enhance seniors’ quality of care, we have continued to see physician payment instability in the Medicare program. This uncertainty, in addition to other regulatory burdens, creates challenges for providers and, ultimately, the beneficiaries they serve. This hearing will examine these long-standing challenges and help identify solutions to stabilize physician payment and protect seniors’ access to care.”
Dr. Farzad Mostashari, co-founder and CEO of Aledade, provided written testimony before the subcommittee. He said that while Congress intended MACRA to encourage practices to join Advanced Alternative Payment Models (AAPMs), implementation has not delivered a clear distinction between fee-for-service models and AAPMs. Mostashari said that Congress should fix the AAPM bonus by making it more timely and targeted toward practices bringing new Medicare beneficiaries into Accountable Care Organizations (ACOs). He also recommended reducing quality reporting burdens in MSSP ACOs by focusing measurement on a sample of Medicare beneficiaries rather than all patients seen by participating practices.
Mostashari said that ACOs are now coordinating care for over 13 million beneficiaries through more than 580 organizations nationwide. He noted that since 2018 there has been an 18.5% difference in cost growth between MSSP-aligned beneficiaries compared with non-aligned ones by 2024. According to Mostashari’s testimony, this has resulted in $63.7 billion in reduced cumulative Medicare spending over six years.
The testimony further addressed policy adjustments such as eliminating ratchets that lower future benchmarks for successful ACOs—particularly those affecting rural communities—and amending rebasing policies so high-performing organizations can retain more savings after contract periods end. Mostashari also called for improved cash flow options for primary care practices participating in MSSP as well as empowering ACOs to help fight fraud within Medicare claims data.
The hearing will be open to both public attendance and press coverage with livestreaming available online at energycommerce.house.gov. More information can be found at the organization’s press release.
