The advocacy priorities that AMA President Bruce A. Scott, MD, is fighting for every day in his leadership role—fixing Medicare physician payment and prior authorization, foremost among them—are hitting home in his independent otolaryngology practice in Louisville, Kentucky.
“As a physician who continues to practice in a small private practice, I can tell you that I live these issues every day,” Dr. Scott said in an episode of “AMA Update” last month. “And frankly, our practice is struggling under the financial cuts of Medicare and the continuing waste of our time as we get on the phone and have to fight for our patients to get the care that together we've decided is in their best interest.
“Two of my partners have given up,” he noted regretfully. “And as of Jan. 1, they're leaving private practice, and they're going to become employed. Not because they want to leave private practice—but because the challenges that we're talking about.”
Before seeing how these broken health care policies contributed to his colleagues’ leaving private practice, Dr. Scott—who was inaugurated as the AMA’s 179th president last June—has encountered countless similar stories from other doctors.
“For physicians all around the United States, as I travel, I hear that they're struggling,” he said, noting that a close friend who is an ob-gyn had to close up shop after more than two decades of solo practice.
Medicare reform tops priority list
For the fifth consecutive year, “Congress failed patients and failed physicians,” Dr. Scott noted. “At the end of 2024, they allowed yet another Medicare cut to go into effect. This is a 2.8% cut on top of the cuts that we've experienced since 2001, adding up to more than a 30% cut since that time. It's unsustainable. Physicians can't take it anymore.”
Physicians nationwide are frustrated by the lack of progress to fix Medicare, and so is Dr. Scott.
“Year after year we face these cuts,” he said. “We need a Medicare payment system that is based upon what it actually costs us to provide care to the patients.”
But there is a bit of good news on this issue, which is that the AMA has led the effort to “spread the message” about the problem in Congress, “and now we actually have a majority of the people on Capitol Hill who understand the urgency that we must fix Medicare now, or there's going to be a disastrous effect on the access of care for those patients who need it the most—the senior citizens and the vulnerable people who have disabilities.”
A bipartisan group of 10 House members introduced a bill last week to stop the 2.8% cut in Medicare payments to physician practices this year while providing a 2% payment update.
The AMA strongly supports the legislation and will work with members to include it in upcoming legislation to fund the federal government beyond the March 14 statutory deadline.
Reps. Greg Murphy, M.D. (R-N.C.) and Jimmy Panetta (D-Calif.), along with eight other House members, introduced the Medicare Patient Access and Practice Stabilization Act (PDF). This legislation, effective April 1, would prospectively cancel the 2.8% percent cut that took effect Jan 1. Similar legislation enjoyed bipartisan, bicameral support, but Congress failed to address the issue during the lame duck session.
That latest congressional failure came despite AMA’s leading the charge to reform the Medicare payment system to avoid what Dr. Scott has called an “oncoming crisis” in medical care.
That advocacy garnered bipartisan majority support (PDF) in the House of Representatives for leadership to “expeditiously pass legislative fixes” to stop the “harmful” pay cut and give doctors an update “that takes into account the cost of actually delivering care to patients.” That letter to congressional leaders also urged Congress to provide a positive payment update for 2025. Every state medical society signed on, as did 77 national medical associations.
The AMA’s Fix Medicare Now campaign last year generated over 60 million paid impressions, nearly 700,000 engagements, and almost 507,000 messages to Congress.
Dr. Scott said he and others at the AMA will “be up on Capitol Hill in this next Congress fighting for a reversal of these cuts and a reform of the Medicare payment system to provide physicians a payment update that is based upon the cost of providing care.”
The AMA is strongly encouraging physicians from around the country to come out in force for the AMA National Advocacy Conference in Washington, D.C., Feb. 10–12. The goal is to show Congress the real-life impact of the broken Medicare payment system on patients and on physician practices and the communities across America that doctors serve. Learn more and register now.
The agony of prior authorization delays
Along with pushing for Medicare payment reform, the AMA is fighting to fix prior authorization by challenging insurance companies to eliminate care delays, patient harms and practice hassles.
“My patients feel this problem. They're frustrated, and they're growing angry,” said Dr. Scott, an otolaryngologist and head-and-neck surgeon. He shared the story of a recent “patient who had a tumor in his throat that we were concerned might be cancer.” The patient and his family had to wait “over two weeks for his insurance company to approve the biopsy so he could find out whether he had cancer of his throat or not.”
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And, such stories are not rare or limited to cancer care.
“This is the sort of stress that patients all around the United States, in my practice, and in other practices, are experiencing simply because insurance companies want to save their profits. It's unacceptable,” Dr. Scott said.
There has been some progress in this area, with a big win coming early last year when the AMA convinced the Centers for Medicare & Medicaid Services to “add transparency and reduce delays, and add efficiencies to prior authorization in government-sponsored health care plans.”
In addition, the AMA “worked with state medical associations to get reform of prior authorization in the states. And we were successful in over 12 states in getting new prior authorization reform.”
The AMA won’t stop fighting there.
“We'll be going back to the federal legislation this next session, and we'll continue to work with the state medical associations to get more prior authorization reform,” Dr. Scott said. “The bottom line is prior authorization delays needed care and harms patients.”
Dr. Scott also outlined the AMA’s other advocacy priorities. From reducing physician burnout to defending against scope creep, the AMA is fighting for you, so you can stay focused on your patients. Hear more from our AMA members.
“AMA Update” is your source for physician-focused news. Hear from physicians and other experts on trending public health concerns, practice issues and more—because who’s doing the talking matters. Catch every episode by subscribing to the AMA’s YouTube channel or listen to all AMA podcasts at ama-assn.org/podcasts.
