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An Unsustainable Status Quo
An Unsustainable Status Quo:
House Energy & Commerce Subcommittee Hearing on Medicare Physician Payment Spotlights Needed Reform
AMGA Calls for Immediate Action
"The hearing sent an unmistakable message: The status quo is unsustainable," said Jerry Penso, MD, MBA, president and CEO of AMGA. "The testimony reinforced what our members report. Payment instability is forcing practices to limit Medicare enrollment, furlough clinical staff, and curtail population health programs that patients depend on. We thank the subcommittee for its leadership and urge Congress to move swiftly from conversation to legislation."
On May 20, 2026, the House Energy & Commerce Subcommittee on Health held a hearing titled, Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms. Ten Republicans and 12 Democrats attended the hearing. There was a broad, bipartisan consensus that the Medicare Physician Fee Schedule needed reform, with members and witnesses from across the nation agreeing that the lack of an annual inflationary update has driven independent practices to consolidate with large hospital systems or close entirely.
The hearing provided an important forum for examining the structural failures in Medicare physician reimbursement and exploring the reforms needed to protect patient access and sustain high-quality care. Witnesses and members on both sides of the political aisle strongly supported tying Medicare physician payments to the Medicare Economic Index (MEI) to help physician practices keep pace with rising overhead costs.
The hearing's testimony and discussion demonstrated what AMGA members have experienced firsthand: The Medicare physician payment system is broken. Since the Medicare Access and CHIP Reauthorization Act's (MACRA's) enactment in 2015, the Medicare Physician Fee Schedule conversion factor has fallen more than 30% after adjusting for inflation, even as practice operating costs have risen approximately 20% over the same period. Successive rounds of temporary patches have failed to address this structural deficiency, which left unaddressed will undermine the ability of clinicians to provide care.
AMGA is prepared to assist Congress in addressing Medicare reform. In 2023, AMGA convened the AMGA MACRA and Value-Based Care Task Force, a group of physician executives from leading multispecialty group practices and integrated health systems, to develop consensus-based, forward-looking policy solutions. Over two years, the Task Force examined the reimbursement and regulatory landscape and produced recommendations organized around six pillars:
- Enhancing patient engagement
- Improving health outcomes
- Protecting patient dignity at end of life
- Removing regulatory and statutory barriers
- Supporting practices serving rural and underserved populations
- Ensuring the long-term sustainability of high-value care
"The issues examined today are not hypothetical, but are reshaping care delivery in communities across the country," Penso added. "Our Task Force has done the work. We have the policy solutions ready. We urge Congress to act now before more practices are forced to make irreversible decisions that will limit access for Medicare patients for years to come."
AMGA urges Congress to use the Task Force recommendations as a blueprint for MACRA reauthorization and broader Medicare reform efforts. AMGA stands ready to work with Congress and other stakeholders to implement these changes and fulfill the original promise of MACRA: a stable, predictable payment system that rewards high-quality, high-value care.
