Primary Care Community Urges Congress to Protect Efficiency Adjustment

In a letter dated December 15, addressed to Congress, national and state organizations urged Congressional leaders to protect the efficiency adjustment implemented by the 2026 Medicare Physician Fee Schedule (MPFS).

“For decades, the PFS has consistently undervalued primary care, behavioral health and other time-based services relative to many other services,” the organizations noted in the letter to leaders from both parties in the House and Senate. “This rule does not solve every problem in the PFS, but this provision helps move the system toward greater support for primary care.”

“Today, more and more Americans struggle to access the type of high-quality, whole-person primary care we know leads to better health,” said President and CEO of the Primary Care Collaborative, Ann Greiner, in a statement. “The 2026 MPFS is an essential step forward toward improving access for millions who can’t get needed care due to Medicare’s chronic underinvestment in primary care. Congress should reject calls to undo that progress.”

The letter writers underscored their support for CMS’s decision to exclude evaluation and management (E/M) services from the efficiency adjustment. “Much of this care has become more complex and oriented around a patient-centered comprehensive approach to care that is inherent and unique to primary care.”

The letter featured signatures from primary care advocacy organizations such as the Primary Care Collaborative, American Academy of Family Physicians, American College of Physicians, Blue Shield of California, Families USA, Mental Health America, the National Alliance of Health Care Purchaser Organizations, the National Association of Community Health Centers, and Village MD.