AMA: US Healthcare System Headed for Success After 2022 Hurdles

Medicare payment cuts and physician burnout continue to hurt the country’s healthcare system, but federal and state policies implemented in the past year have created a promising path forward, according to Jack Resneck Jr, MD, president of the American Medical Association (AMA).

On June 9, 2023, Resneck delivered the final speech of his presidency to the AMA House of Delegates. He will become the organization’s Immediate Past President after his run ends on June 13.

Resneck highlighted how ongoing physician burnout threatens to exacerbate staffing shortages in the healthcare space. One in five physicians plan to leave their practice within two years, while one in three are reducing their hours, he noted. In addition, just 57 percent of current doctors would choose medicine again if they were at the beginning of their careers.

Physician burden in the last year has stemmed from prior authorization hurdles, Medicare payment cuts, medical misinformation, and political involvement in care decisions.

“We absolutely must tie future Medicare payments to inflation, and we’re readying a major national effort to finally achieve Congressional action,” Resneck said.

In April, four lawmakers introduced the Strengthening Medicare for Patients and Providers Act in the House, which would link the Medicare Physician Fee Schedule to the Medicare Economic Index.

“Duct-taping the widening cracks of a dilapidated Medicare payment system isn’t sustainable. Linking physician payment to inflation is an absolute top priority, an existential must to keep practices afloat, and pillar #1 of the plan,” added Resneck.

Prior authorization policies have also disrupted physicians’ workflows. However, Resneck mentioned legislative action that will help minimize prior authorization requirements and streamline the process.

For example, CMS implemented its 2024 Medicare Advantage and Part D Final Rule, which establishes new guidelines for health plans regarding prior authorization. Among other changes, health plans must only use prior authorization to confirm the presence of a diagnosis or other medical criteria and ensure that an item or service is medically necessary.

Despite widespread misinformation and the politicization of healthcare issues, policymakers and the general public are making strides in the right direction, Resneck asserted.

Lawmakers on both sides of the aisle are on board with prior authorization reform, indicating a future with fewer care delays and less administrative burden.

After facing stark COVID-19 inequities, Mississippi now has one of the nation’s top vaccination rates among Black residents.

Even as legislatures try to criminalize abortion and limit access to reproductive healthcare, many people support the fundamental rights of patients to make their own decisions about their health, Resneck highlighted.

In addition, medical school applications are at an all-time high, despite physician burnout and staffing shortages.

Under the AMA Recovery Plan for America’s Physicians, the organization has helped extend Medicare telehealth coverage, limit scope of practice expansions—which AMA maintains threaten patient safety—establish wellness programs for physicians, and reform licensing and credentialing forms.

AMA has also influenced key provisions beyond the Recovery Plan to help improve the nation’s healthcare system, Resneck said.

The Federal Drug Administration (FDA) is making Naloxone, a medicine that reverses opioid overdose, available over the counter and may be doing the same for oral contraceptives. Resneck also highlighted the FDA’s expansion to allow gay and bisexual men to donate blood.

Medicaid work requirements opposed by AMA were left out of the debt ceiling bill, and AMA increased its efforts to address structural and social drivers of health inequities.

“Our litigation center has been very, very busy. We’ve joined others in suing Cigna for shortchanging doctors and patients. We forced the federal government to take steps towards banning menthol cigarettes,” Resneck shared.

“Courts have invalidated parts of No Surprises Act rules that plainly ignored Congressional intent and put a thumb on the scale to favor insurance companies…thank you, Texas Medical Association and AMA."