MGMA raises alarm over 2026 Medicare Physician Fee Schedule, warns of access crisis
The Medical Group Management Association (MGMA) is voicing strong concerns about the proposed 2026 Medicare Physician Fee Schedule, saying that years of cuts and congressional inaction are pushing independent practices to the brink and threatening patient access to care.
“Unfortunately, in 2025, physicians on average have received a 2.83% cut in Medicare. So we're already kind of in a hole this year,” said Anders Gilberg, MGA, senior vice president of government affairs at MGMA in a video interview with HealthExec. “While Congress added 2.5% to next year, we're still in a hole. It really boils down to an access problem for Medicare beneficiaries if they don’t have access to the medical practices in their community.”
The controversy stems from the end of 2024, when lawmakers appeared poised to roll back part of the looming cut for this year. According to Gilberg, the fix proposed in December was included in a bipartisan budget resolution—until a series of high-profile tweets from Elon Musk criticized the size of the federal budget package. Congress responded by stripping out hundreds of pages from the bill, including the physician pay relief, leaving practices exposed to a new round of cuts.
Although lawmakers promised a partial increase beginning in 2026, MGMA argues that the math does not add up.
“When you cut a certain percentage, sometimes you need that much more to get out of that hole,” Gilberg explained. “We will not have a higher conversion factor in 2026 than we did in 2024.”
For MGMA, the debate is not about protecting high-earning doctors, but about sustaining the infrastructure that keeps practices running. Medicare physician reimbursements flow directly into paying nurses, technicians, front-office staff, rent and overhead.
“Being here in Washington, this issue gets spun as some kind of salary issue for physicians, and that’s not the case at all,” Gilberg said. “The payments under the fee schedule, they do keep the lights on.”
The financial pressure has been a key factor accelerating consolidation of private practices in medicine, pushing more physicians into hospital employment or private equity-backed groups. Independent cardiology practices, for example, have nearly disappeared over the past decade—a trend Gilberg links directly to Medicare reimbursement policies.
“It just makes it very hard for independent practices to survive because they rely solely on the Medicare physician fee schedule,” he said.
MGMA warns that if Congress does not pursue comprehensive payment reform, access to care, the impact will be felt most prominently in rural and underserved.
“If a community in a rural area cannot attract physicians because they can’t pay off their student loan debt, that just provides an access problem that we’re exacerbating by these cuts,” Gilberg said. He noted most doctors today graduate with an average of $500,000 of student loan debt.
With more than 33% in lost physician reimbursement since 2000, adjusted for inflation according the the American Medical Association, MGMA argues that the new schedule represents only a temporary patch, not a solution. The group is calling for Congress to address the underlying structural flaws in Medicare physician payment before more independent practices close their doors.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]