Sustainable Physician Reimbursement

Modified May 2024

Medicare reimbursement rates are crucial for independent urologists, significantly impacting the financial viability of their practices. Fair and adequate reimbursement rates ensure that urologists can provide high-quality care to Medicare beneficiaries without incurring financial losses. Insufficient reimbursement rates can lead to reduced access to care, limited resources for investing in advanced technology, and challenges retaining skilled healthcare professionals.

LUGPA advocates for fair and sustainable Medicare reimbursement rates for urologists to address this issue. LUGPA engages in dialogue with policymakers and legislators to raise awareness of the importance of appropriate reimbursement rates for independent urologists and their patients. By advocating for reasonable and updated reimbursement rates, LUGPA aims to support independent urologists in providing the best possible care while maintaining the financial stability of their practices.

MACRA Reform

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) reform, Medicare reimbursement rates, and Medicare fee schedules influence the payment models and incentives for healthcare services, encouraging efficient and high-quality care delivery.

Reforming MACRA is crucial for the program's long-term viability. MACRA's flawed pay-for-performance programs pit providers against each other and fail to drive physicians toward value-based care. The disconnect between the current Medicare physician payment policy and the expenses incurred by independent practices leaves urologists struggling financially, leading to burnout, early retirement, and the physician shortage.

As a group greatly affected by these issues, LUGPA emphasizes protecting physicians by providing stable payment updates that reflect economic realities and healthcare practice costs. LUGPA has submitted comments to Congress on improving MACRA and Physician Payment Reform, recommending:

Developing physician-focused payment models
Repealing the ineffective MIPS program
Providing meaningful payment rewards for high-performing practices
Ensuring site neutrality payments to maintain patient access and control healthcare costs

Through these efforts, LUGPA aims to support sustainable physician reimbursement, ensuring independent urologists can continue delivering high-quality patient care.