- AMA Board Chair testifies before Congress on health care affordability and patient access
- Medicare enrollment decisions to be discussed in June report to Congress
- Submit letters of intent for new CMS lifestyle intervention grants by April 10
- Preeclampsia Foundation announces postpartum wristband initiative at HHS National Conference on Women’s Health
- More articles in this issue
AMA Board Chair testifies before Congress on health care affordability and patient access
On March 18, AMA Board of Trustees Chair David H. Aizuss, MD, testified (PDF) before the House Energy and Commerce Subcommittee on Health at a hearing entitled Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape.
Representing physicians nationwide, Dr. Aizuss made it clear: when physician practices face financial challenges, patients end up in higher-cost care, wait longer for appointments, and struggle with access— especially in areas with fewer health care options. He warned Congress that the United States is seeing a rapid transition away from independent physician practices into higher-cost settings, driving up spending for both patients and federal health programs. He testified that driving this trend was market consolidation, inadequate physician payment, burdensome prior authorization rules, coverage instability and physician workforce shortages.
Dr. Aizuss called on lawmakers to take action now to support independent physician practices, ensure patients can see their doctors without delay, and reduce health care costs for everyone by:
Preventing the 2.5 percent Medicare cut scheduled for the end of 2026
Reforming Medicare’s outdated budget neutrality requirements to stop more annual Medicare cuts
Establishing a real inflation update tied to the Medicare Economic Index (MEI) to reflect rising staffing, technology, and compliance costs
Reforming the MIPS program to ensure that small, rural, and independent practices are protected from steep payment penalties and ensure physicians receive timely performance data
Reducing administrative and regulatory burdens by passing prior authorization reform legislation and reforming the Medicare MIPS quality reporting program
Expanding competition and patient access by restoring the ability of physicians to open and expand physician-owned hospitals
Passing legislating to address the severe physician workforce shortage in the United States
As changes to Medicaid move forward, ensuring eligible patients do not lose coverage and physicians can sustainably participate in the program
Top issues are the hearing were structural reforms to reduce consolidation and increase competition, including repealing the physician-owned hospital ban, reforming the 340B program, improving price transparency enforcement, impact of the Medicaid cuts, vaccine policies, paperwork burdens on physicians and physician workforce shortages. Of particular interest, members of both parties expressed concerns about inadequate Medicare physician reimbursement and the impact that has on the viability of independent physician practices, patient access, competition and overall health care costs. This included Subcommittee Chairman Morgan Griffith (R-VA), Rep. Gus Bilirakis (R-FL), Rep. Raul Ruiz., MD (D-CA), Rep. Neal Dunn, MD (R- FL), Rep. Nanette Barragan (D-CA), Rep. John Joyce, MD (R-PA), Rep. Marc Veasey (D-TX), Rep. Mariannette Miller-Meeks, MD. (R-IA), Rep. Erin Houchin (R-IN), and Rep. Greg Landsman (D-OH). Reps. Ruiz and Miller-Meeks endorsed providing physicians with a Medicare inflation update at full MEI.
Other witnesses included:
Richard Pollack, president and CEO, American Hospital Association
R. Shawn Martin, executive vice president and CEO, American Academy of Family Physicians
Elizabeth Mitchell, president and CEO, Purchaser Business Group on Health
Anthony DiGiorgio, DO, MHA, neurosurgeon, University of California San Francisco Health
Barbara Merrill, CEO, American Network of Community Options and Resources
Medicare enrollment decisions to be discussed in June report to Congress
The AMA submitted comments (PDF) this week to the Medicare Payment Advisory Commission (MedPAC) expressing appreciation for its discussion of a chapter for its June 2026 report highlighting the complexity of choices facing Medicare beneficiaries when they initially enroll in the program and at each open enrollment period. Many commissioners expressed concern about the contrast between the large number of factors involved in choosing between traditional Medicare and Medicare Advantage (MA) and the absence of trusted and objective sources of information to assist beneficiaries. MedPAC also highlighted a similar lack of information on the late enrollment penalties facing people if they do not enroll in Medicare during the seven-month window of their initial eligibility.
AMA comments expressed agreement with the concerns raised by commissioners. In addition, the letter noted that, although these enrollment decisions are complex, the AMA believes that many beneficiaries lack more fundamental information about how these health insurance programs work. For example, in traditional Medicare, patients can generally see any physician who accepts Medicare patients, whereas MA plans operate through networks and patients will likely need to change physicians if their doctor is not included in the plan’s network. Depending on how narrow or expansive the network is, patients may find it more difficult to locate a specialist when needed or experience longer wait times for appointments.
Out-of-pocket costs are also different. Some beneficiaries may choose a MA plan because they believe they will spend less than they would in traditional Medicare, or if they pay for traditional Medicare and a Medigap supplemental premium. However, even with MA out-of-pocket spending limits, patients may not be aware that MA cost-sharing requirements can still pose difficulties, especially for patients who need chemotherapy medications or other high-cost services. Unlike Medigap premiums, these costs are unpredictable.
The comment letter also raised the important issue of prior authorization, noting that patients are far more likely to face prior authorization for referrals, tests, procedures, therapies, and admissions in MA than traditional Medicare. Beneficiaries should be educated on all these issues so that they can make informed choices. The AMA expressed appreciation to MedPAC for planning to include this chapter in its report and looks forward to the commission’s future work in this area.
Submit letters of intent for new CMS lifestyle intervention grants by April 10
The Centers for Medicare & Medicaid Services (CMS) recently posted a notice of funding opportunity for its new Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (ELEVATE) Model. The model will provide approximately $100 million to fund up to 30 proposals that utilize evidence-based, whole-person care approaches including functional or lifestyle medicine interventions to improve health and prevention for original Medicare beneficiaries. Models will operate over three years and feature two cohorts, the first starting in October 2026. Physician practices, health systems, and Accountable Care Organizations, Federally Qualified Health Centers, and Rural Health Clinics are encouraged to apply. Individual applicants may make multiple submissions. The award ceiling for each project is $3.3 million. Recipients will be selected based on five criteria:
Whole-person FLM intervention design, including cost savings
Beneficiary recruitment and study design
Organizational and administrative capacity
Data management capabilities
Budget
Interested applicants must submit a mandatory letter of intent by April 10, 2026. The application deadline is May 15, 2026.
Preeclampsia Foundation announces postpartum wristband initiative at HHS National Conference on Women’s Health
On March 4, the AMA sent a letter (PDF) to the Preeclampsia Foundation expressing its support for the Foundation’s “Still at Risk” postpartum hypertension awareness and action wristband initiative. This public-private partnership is focused on improving postpartum health outcomes through the creation, promotion, dissemination and impact measurement of wristbands for postpartum women at risk of developing hypertension.
On March 12, the Preeclampsia Foundation announced the launch of the “Still at Risk” initiative at the U.S. Department of Health and Human Services’(HHS) National Conference on Women’s Health. The AMA, alongside the American Heart Association, and Premier Inc., provided remarks expressing the importance of collaboration in addressing dangerous health care challenges. Dorothy Fink, MD, deputy assistant secretary for women's health and director of the Office on Women's Health in the Office of the Assistant Secretary for Health (OASH), shared that HHS is “proud to be part of this important initiative.”
