March 5 - March 19, 2025

Welcome to The Partnership to Empower Physician-Led Care biweekly newsletter, which includes news from our members, legislative and Administration updates, news clips, and studies about value-based care, primary care, and independent physicians. 

 Administration News  

CMS (3/12) – The CMS Innovation Center announced changes to its model portfolio to align with its statutory obligation and strategic goals. This includes terminating four models earlier than initially planned (Making Care Primary, Primary Care First, ESRD Treatment Choices (ETC) and Maryland Total Cost of Care) and not implementing two previously announced models (Medicare $2 Drug List and Accelerating Clinical Evidence). Providers participating in these models will have the remainder of the year to consider options for 2026, which include ACO Primary Care Flex, ACO REACH and the AHEAD model (in certain states). CMS will release additional details in a forthcoming new strategic direction.

 Legislative News  

H.R. 1968 (3/15) – Congress passed the Full-Year Continuing Appropriations and Extensions Act of 2025, which funds the federal government until September 30, 2025. While it includes several health care provisions, such as extending Medicare telehealth flexibilities, it did not include an offset the nearly three percent Medicare Physician Fee Schedule cut or extend the Advanced APM bonus. Rep. Murphy (R-NC), co-chair of the GOP Doctors Caucus, stated he was promised a physician payment fix would be included in a reconciliation bill later this year.

The California Medical Association (CMA) and Medical Group Management Association (MGMA) each released statements on the government funding bill:

• “CMA is outraged by Congress’ utter failure to prevent yet another catastrophic cut to Medicare physician payments, despite bipartisan support for fixing our broken Medicare program and improving patient access to care. This year’s cut is the fifth consecutive year of cuts to physicians, and it will inflict irreparable damage on physician practices and undermine care for patients.”
• "While it is the inherently flawed MACRA that has led to these five consecutive years of declining Medicare reimbursement, until Congress can enact comprehensive physician payment reform, they must protect the financial viability of medical practices by passing legislation to, at a bare minimum, avert the cut each year.”

MedPAC (3/15) – The Medicare Payment Advisory Commission (MedPAC) released its 2025 report to Congress, which evaluates the adequacy of FFS Medicare’s payments and makes recommendations for how those payments should be updated for 2026.

• Healthcare Dive (3/15) MedPAC recommends Congress tie physician pay to inflation for 2026 – The Medicare Advisory Payment Commission, which advises Congress on Medicare policy, is recommending tying the rate of physician and other health professionals’ payment increases in 2026 to the Medicare Economic Index minus one percentage point. Provider groups have been pushing MedPAC to tie payment increases to the MEI, saying rate increases need to better keep up with the costs of providing care. However, groups are split as to whether the recommendation goes far enough in addressing rising costs.

News Clips  

Modern Healthcare (3/19) Site-neutral Medicare pay eyed to fund Trump tax cuts – While congressional Republicans hunt for hundreds of billions of dollars in health care cuts, an old, bipartisan idea seems poised for a comeback: "site-neutral" Medicare reimbursements for outpatient care. This policy, which the hospital sector opposes and health insurers endorse, would require health systems to charge the same prices for services whether they are performed in a hospital or another location. Lawmakers advanced numerous proposals in 2023 and 2024 that would have implemented some version of site-neutral payment rules, such as barring hospitals from adding facility fees to claims or setting higher prices for services such as telehealth services or off-site drug injections.

Becker's Physician Leadership (3/14) How 1 physician went independent and never looked back – In his various phases of employment, Dr. Haus witnessed the erosion of patient-centered care through increasingly restrictive referral policies, practice hours and other aspects of practice management. “Putting patients first, treating patients as you like to have your own family members treated … that just doesn’t happen, he said. “You can’t even do what’s best for your patients. This prompted his gradual shift back to private practice in 2007.

Brown Daily Herald (3/1) Primary care physicians are moving to hospitals and private equity, raising healthcare costs, study finds – Almost half of all primary care physicians are affiliated with hospitals, and an increasing number of physician practices are being acquired and consolidated by private equity firms, according to a recent study by Brown researchers. Compared to independent firms, these consolidated firms may lead to increased costs and limit access to primary care providers for patients. Between 2009 and 2022, the percentage of PCPs employed by hospitals rose from 25.2 percent to 47.9 percent, while 1.5 percent of PCPs “became affiliated with PE firms,” the study found.

Events

March

• March 19, 2025 – Duke Margolis Center for Health Policy, “The Future of Accountable Care: Potential Paths to Making "Alternative" Payment Models the Norm.”
• March 26, 2025 – The Hill, “Health Next Summit.”

If you would like your event to be included in the next newsletter, please email sarah@physiciansforvalue.org