MedPAC Continues Review of Physician Payment Reforms

The independent Medicare Payment Advisory Commission (MedPAC) that advises Congress about Medicare continued to examine physician payment policies and clinician quality programs during its October meeting. The examination is part of the commission’s work on its 2027 report to Congress.

MedPAC staff presented several issues affecting the accuracy of the Medicare physician fee schedule, including global surgical payments, "incident to" billing and telehealth payment policy. Commissioners focused on concerns that Medicare may pay for more postoperative visits than clinicians actually provide under global surgical payment bundles. While discussion is ongoing, several commissioners expressed support for updating payment rates to better reflect actual care patterns while maintaining the bundled payment structure.

The commission also reviewed clinician quality incentive programs established under the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act, including the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Commissioners reiterated longstanding concern that MIPS remains complex, burdensome and dependent on hundreds of self-selected measures that make it difficult to compare clinician performance. They noted that the program often produces only small payment adjustments and may disadvantage safety net providers.

The meeting provided a foundation for MedPAC's continued analysis of physician payment accuracy, quality measurement and value-based care models. The commission is expected to further explore these topics as it develops recommendations for Congress.

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