Naturally, independently owned & operated orthopedic practices are concerned about the reduction. While CMS correctly accounts for the increased efficiency of the surgical procedures and patient stay in facilities, the reduction does not account for all of the physician and practice investment to make those efficiencies. Medical device advancements, additional training, increases in overhead and the required technology platforms required by Medicare to participate. Just like everything else, all of those things doing the opposite of getting cheaper.

This affects independent practice the most due to a variety of factors. Typically, physician owned practices don’t have the conglomerated capital to absorb these reductions. the AAOS argues that the extra reduction will add a disproportionate liability to the surgeon that does not reflect the same level of technical responsibility, liability, preoperative decision making or operatives risks for the 90 days post surgery. Their argue to retain the 2026 reimbursement schedule while realistically sustainable plans are developed. 

Historically, the AMA cites medicare physician reimbursement from 2001-2026 saw a payment reduction of 33% (adjusted for inflation). A further 20% reduction would be a drastic blow to the physician. AAOS argues that this kind of downward pressure squeezes privately-owned practices and individual physicians to potentially consolidate into larger conglomerates, rely on hospital system employment or even reduction in services that are hard to bill for separately. The expectation is that with