Overview
- CMS released the proposed 2027 Physician Fee Schedule on July 14, which would lower pay for most clinicians by an estimated 1.68% and by 1.19% for those in qualifying advanced alternative payment models.
- The rule would set two conversion factors — a higher one for qualifying APM participants (about $33.17) and a lower one for others (about $32.84) — reflecting the end of a one-year congressional boost from 2026.
- CMS would phase out traditional MIPS reporting by 2029 and require clinicians to move into specialty-focused MIPS Value Pathways that aim to tie payment adjustments to more clinically relevant measures.
- The proposal overhauls the Medicare Shared Savings Program with new benchmarking and incentive changes designed to increase ACO participation and let some ACOs reduce patient out-of-pocket costs starting April 1, 2027.
- CMS also seeks stakeholder input on duplicate testing and EHR interoperability, plans multi-year changes to practice-expense calculations and coding rules, and has drawn immediate criticism from physician groups while prompting a bipartisan bill to tie pay to inflation.