Health Affairs analysis calls for Medicare payment reform to better value primary care

Medical Economics September 4, 2025
Austin Littrell, Keith A. Reynolds

Key Takeaways

• Income disparities between specialists and primary care physicians disincentivize new physicians from entering primary care, worsening shortages and access issues.
• The Physician Fee Schedule undervalues cognitive work in primary care, favoring procedural specialties with higher relative value units.
• The Relative Value Scale Update Committee’s underrepresentation of primary care and opaque processes contribute to imbalanced payment values.
• CMS’s introduction of new codes for chronic condition management in 2025 aims to address payment gaps, but further reforms are necessary to sustain primary care.

New analysis argues that Medicare’s payment system undervalues cognitive effort in primary care, contributing to physician shortages and reduced patient access.

In 2025, it’s harder than ever to access primary care in the United States,...

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