AMA offers CMS a path to strengthen private practice and access to care

In submitting comments (PDF) today on the 2026 Medicare Physician Fee Schedule, the American Medical Association (AMA) offered to work with the Centers for Medicare & Medicaid Services (CMS) on policy changes that aim to preserve private practice and maintain access to health care.

The AMA has recommended linking payment updates for physician practices to the growth in the cost of providing care, a position shared by the Medicare Payment Advisory Commission.

“Inadequate physician payment has real-world consequences (PDF), accelerating the trend in consolidation and worsening seniors’ access to care. To protect Medicare for the next generation, we urge the Trump Administration to support any congressional action to enact inflation-based updates for physician payments, such as the provision tied to the Medicare Economic Index (MEI) that was in the House-passed reconciliation bill,” the letter said.

The AMA noted that two CMS proposals (PDF), however, inadvertently go in the opposite direction of bolstering private practice. Specifically, the efficiency adjustment would result in cuts to more than 7,000 physician services—95 percent of services provided by physicians. The AMA suggests an alternative mechanism to increase primary care payment and augment the time data used in the payment system.

CMS also proposed a 7 percent reduction in practice expense used in physician payment for services performed in facilities such as hospitals or ambulatory surgical centers. Because this change does not accurately reflect physician resource costs incurred by practices in the facility setting, it may have the unintended effect of reducing competition and encouraging consolidation, results that CMS itself has been eager to avoid.

Together, these proposals would result in 37 percent of oncologists facing cuts between 10 and 20 percent. Also, 37 percent of obstetricians and gynecologists would face cuts. This is not going to make America healthier. The AMA urges CMS to base its policy on verifiable data, including the Physician Practice Information Survey, when making changes to practice expenses. 

The AMA looks forward to continuing the dialogue to ensure that the policy recommendations make Medicare work for our patients and physicians. 

The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.