The recently proposed 2027 Medicare Physician Fee Schedule once again highlights the instability of the current system. The Centers for Medicare & Medicaid Services has proposed reductions to both Medicare physician payment conversion factors, driven largely by the expiration of the temporary 2.5% payment increase enacted by Congress for 2026.

Although the proposed rule includes several policies that may benefit family physicians, including new primary care services and enhanced payment for some physicians participating in accountable care organizations, temporary increases and incremental regulatory updates are not a substitute for lasting congressional reform.

The bipartisan Patients First Act (H.R. 9693) would make meaningful improvements to Medicare physician payment and take important steps toward strengthening primary care. The legislation would:

• Provide annual Medicare physician payment updates based on inflation that better account for rising practice costs;
• Establish a five-year primary care pilot providing prospective, per-patient monthly payments to eligible independent practices;
• Eliminate patient cost-sharing associated with payments made through the primary care pilot;
• Replace the burdensome Merit-based Incentive Payment System with a more meaningful quality and performance measurement program focused on quality, resource use and care efficiency;
• Give physicians a stronger voice in developing specialty-specific quality measures;
• Provide additional support for rural practices during periods of high inflation; and
• Reform Medicare budget-neutrality policies that can contribute to damaging physician payment cuts.

Although additional reforms will be necessary to fully address the challenges facing the Medicare payment system, the Patients First Act represents meaningful bipartisan progress toward better valuing primary care, strengthening independent physician practices and protecting patients’ access to care.

Take Action Now. Urge your members of Congress to co-sponsor the Patients First Act.

Contact your lawmakers today using AAFP's Speak Out template letter.