ASTRO joined more than 125 physician groups asking Congress to prioritize physician payment reforms to the Medicare Access and CHIP Reauthorization Act (MACRA). In response to CMS’s proposed 2.8% reduction in overall physician payments in the 2025 MPFS, physicians across the house of medicine are highlighting continued instability of the current Medicare payment system and the urgent need for policy changes to address patient adversity and rising practice costs.

The 2025 Medicare conversion factor is set to decrease for the fifth straight year by approximately 2.80% from $33.2875 to $32.3562. This cut is largely the result of the expiration of a 2.93% temporary update to the conversion factor at the end of 2024 and a 0% baseline update for 2025 under the Medicare Access and CHIP Reauthorization Act (MACRA). These cuts coincide with ongoing growth in the cost of practicing medicine as CMS projects the increase in the Medicare Economic Index (MEI) for 2025 will be 3.6%.

Physician practices cannot continue to absorb increasing costs with ever-increasing inflation rates, while their payment rates dwindle year after year. The letter urges leadership to act on bills or future legislation which reforms MACRA along four key pillars:

1. Implementing an annual permanent Medicare inflationary payment update;
2. Budget neutrality reforms;
3. An overhaul of the Merit-based Incentive Payment System (MIPS); and
4. Modifications to Alternative Payment Models (APMs).

These are well vetted, consensus reforms within the physician community, and consistent with key features of the Radiation Oncology Case Rate (ROCR) Act (S.4330/HR.7404). ROCR would provide payment relief for radiation oncology by adjusting for budget neutrality, including an inflationary adjustment, tie payments to value (without the burdensome MIPS), and could save Medicare more than $200 million. Contact your Senators and Representatives and ask them to support Medicare payment relief for radiation oncology by cosponsoring the ROCR Act (S.4330/HR.8404).