Source: American Academy of Family Physicians

The proposed rule includes several encouraging provisions for family medicine. CMS would expand the primary care exception, giving teaching physicians more flexibility when supervising resident-delivered care. That could improve timely access for patients while supporting the next generation of family physicians.

CMS also would expand payment for primary care-oriented services, including advance care planning and shared medical appointments, that support the conversations, coordination, and ongoing management at the core of comprehensive primary care.

Additionally, CMS is asking how to redesign primary care payment to better support preventive, comprehensive care—a discussion that should include family medicine. Still, the conversion factors show why Congress must act: Compared to this year, the 2027 qualifying APM conversion factor would be down 1.19% to $33.1693, and the nonqualifying APM conversion factor would decrease by 1.68%.

Due to the expiration of a congressionally mandated 2.5% increase to both conversion factors, the payment cuts could have been much worse. However, CMS’ valuation updates helped soften those reductions, and family physicians are projected to see a positive 1% impact on total allowed charges in 2027. Family medicine sees real gains in this proposal, but lasting stability still requires congressional reform.

For additional information, read the AAFP Blog Medicare Payment Reform has Momentum. Now Congress Needs to Act. by American Academy of Family Physicians Vice President, Government Relations David Tully.