CMS proposes Medicare payment cuts in 2027—physician groups pledge to bring about change
The U.S. Centers for Medicare and Medicaid Services (CMS) has released its proposed rule for the 2027 Medicare Physician Fee Schedule (MPFS). The one-time 2.5% conversion factor increase that was part of the One Big Beautiful Bill Act (OBBBA) officially expires at the end of 2026, leading to payment cuts for U.S. physicians in 2027.
There are two new conversion factors in the proposed rule: one for physicians participating in qualifying alternative payment models (APMs) and one for physicians not participating in those APMs. For physicians participating in qualifying APMs, the conversion factor has decreased by 1.19% to $33.57. For all other physicians, the conversion factor has decreased by 1.68% to $32.84. Again, without the OBBBA increase expiring, these conversion factors would be slightly higher in 2027 than they are in 2026.
Major MIPS changes on the way
CMS also wants to sunset traditional Merit-based Incentive Payment System (MIPS) reporting by 2029 as part of a transition toward “more clinically meaningful” specialty-focused MIPS Value Pathways (MVPs). According to the agency, MIPS was originally launched in 2017 to help Medicare move away from quantity-based care and reward quality. CMS sees this step as the continued evolution of that concept.
One MVP relevant to cardiovascular care is the Advancing Care for Heart Disease. In addition, CMS proposed new MVPs focused on diabetes, hypertension and hospital based care.
“We’re proposing some of the most significant Medicare reforms in recent years to strengthen primary care, expand accountable care, and modernize physician payment,” CMS Administrator Mehmet Oz, MD, said in a statement. “These changes would make it easier for clinicians to focus on prevention, improve coordination for patients and ensure Medicare rewards better outcomes rather than more services.”
Click here for additional details from CMS about the 2027 MPFS proposed rule. The agency is accepting public comments for 60 days.
Initial reactions to the proposed rule
U.S. medical societies are still reviewing this proposed rule, but many have shared initial reactions with their members. The American College of Cardiology (ACC), Society for Cardiovascular Angiography and Interventions (SCAI), and Society of Thoracic Surgeons (STS), for example, shared brief summaries that explored the ways these MPFS changes may impact their specific specialties.
The ACC summarized its early reaction to the proposal. The organization expects reimbursements for cardiovascular services to increase approximately 1% compared to 2026. However, its members remain uneasy about certain aspects of the proposed rule.
"The ACC appreciates CMS' efforts to advance payment and quality policies for Medicare beneficiaries, but we have serious concerns about several provisions in the proposed 2027 MPFS,” ACC President Roxana Mehran, MD, told Cardiovascular Business. “Despite a projected overall increase in reimbursement for cardiovascular services, the proposed rule includes significant reductions to values for several cardiovascular procedures and advances elements of the Ambulatory Specialty Model that the ACC has previously urged CMS to reconsider. We are also concerned by the agency's continued challenges to longstanding physician valuation processes without a clearly defined path forward. At the same time, physicians face another effective cut to payment through the conversion factor, creating additional pressure on practices working to meet the growing burden of cardiovascular disease.”
Mehran added that the ACC is still reviewing this proposal closely. The group plans on sharing additional feedback in the near future.
SCAI, meanwhile, highlighted the fact that CMS is proposing additional cuts to left atrial appendage closure (LAAC) reimbursements. SCAI has collaborated with the ACC and Heart Rhythm Society to fight such cuts in the past, and the group is ready to fight again as necessary.
“SCAI continues to fight against these payment cuts through both regulatory and legislative channels,” the group wrote. “SCAI’s Advocacy Committee and its political arm, SCAI PAC, will review the effects of these cuts and provide more information to SCAI members for further action in the near future.”
STS shared its own concerns that some of these CMS proposals “continue to diminish” reimbursements for hospital-based physicians.
“Policies such as the efficiency adjustment and reductions to practice expenses continue to threaten surgeons’ ability to practice,” the group wrote. “Reimbursement also continues to lag inflation. STS is working with the broader physician community and members of the Republican and Democratic Doctors Caucuses to reform physician reimbursement.”
The American Medical Group Association (AMGA) also issued an early statement, echoing some of the issues raised by STS.
“Once again, CMS has proposed conversion factor updates that fall well short of what it actually costs our members to deliver care,” Jerry Penso, MD, MBA, president and chief executive officer of AMGA, said in a statement. “Last year’s increase was only possible because Congress stepped in with a one-time, one-year fix. That relief has expired, and the proposed rule reflects exactly what we were concerned about: a return to the bare statutory updates required under MACRA, which do not come close to keeping pace with inflation or practice costs.”
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.