Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms

The House Committee on Energy and Commerce held a hearing on May 21, 2026, to examine reforms to the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA), focusing on payment reforms to incentivize value-based care. The discussion centered on challenges faced by physicians, particularly independent and primary care providers, due to declining Medicare reimbursement rates that have not kept pace with inflation, administrative burdens under the Merit-based Incentive Payment System (MIPS), and the impact of payment structures on practice consolidation and patient access. Witnesses, including physicians and healthcare leaders, advocated for stable, predictable annual updates tied to the Medicare Economic Index, reforms to reduce administrative complexity, expansion of alternative payment models (APMs), and addressing disparities in reimbursement that threaten the viability of independent practices and rural healthcare access. The committee also discussed legislation such as the Strengthening Medicare for Patients and Providers Act (HR 6160) and the Radiology Outpatient Ordering Transmission (ROOT) Act, which aim to improve payment stability and reduce unnecessary imaging costs. Members emphasized the need to modernize payment methodologies, support primary care, and prevent further consolidation that increases costs and limits patient choice.