For decades, the prices Medicare pays doctors for different medical services have been largely decided not by Medicare itself, but by a powerful industry group, the American Medical Association.
An A.M.A. committee meets in secret to determine the difficulty and time demands of each type of medical visit, test and procedure, and then recommends to Medicare how much doctors should be paid for performing them.
And for decades, critics have complained that this process unfairly rewards surgeons and other specialists, at the expense of primary care physicians and other generalists.
Medicare officials have been loath to change it because it has spared them from needing their own staff and budget to make such pricing decisions, along with the unpleasant politics of adjudicating conflicts between competing groups of physicians.
“Under the new proposal, Medicare would pay 2.5 % less for every procedure, operation & medical test in 2026, based on data suggesting there have been improvements in “efficiency” over the years.”https://t.co/vZDu3kwjC4
— Howard Liu, MD MBA (@DrHowardLiu) July 21, 2025