You could have an easier time finding and keeping a doctor who accepts Medicare if a new bipartisan proposal becomes law. The Patients First Act, H.R. 9693, would change how Medicare pays physicians, measures care quality, and supports medical practices. Although the proposal focuses on doctors, it matters to you because unstable payments can affect appointment availability, physician participation, rural healthcare access, and the long-term strength of your care.
What is the Patients First Act?
It’s a bipartisan bill designed to replace temporary Medicare physician payment fixes with a more predictable system. Under current law, the yearly payment updates received by most physicians can remain nearly flat even when wages, medical supplies, technology, rent, insurance, and other practice costs rise. When payment fails to keep pace with those expenses, you may see a practice reduce its services, join a larger health system, stop accepting new Medicare patients, or close altogether.
The proposal would establish an automatic annual payment update connected to the Medicare Economic Index. You can think of this index as a measure of inflation affecting the cost of operating a medical practice. Most physicians would receive an update equal to the index minus one percentage point. Qualifying participants in certain alternative payment models would receive the index minus half of one percentage point. The update would also have limits intended to make yearly changes more stable and predictable.
Why does an inflation-based update matter to you? A reliable payment system could give your doctors greater confidence that Medicare reimbursement will reflect at least part of their rising costs. That wouldn’t guarantee that every doctor would accept Medicare, and it wouldn’t automatically increase your benefits. It could, however, reduce some of the financial pressure that causes practices to restrict the number of Medicare patients they serve.
The bill would also revise Medicare’s budget-neutrality policy. Medicare generally must offset certain increases in physician spending with reductions elsewhere in the Physician Fee Schedule. Even a projected change in the use or value of a service can contribute to broader payment cuts. The legislation would raise the dollar threshold that triggers these adjustments and require more regular review of the information used to calculate payments. You could benefit from fewer sudden, across-the-board reductions that make it harder for practices to plan.
Changing How Medicare Measures Quality
The Patients First Act would change the way Medicare evaluates physician performance. You may not see the reporting process behind your appointments, but your doctor and medical staff can spend considerable time collecting data, documenting measures, and meeting program requirements. Time and money devoted to complex reporting can reduce the resources available for scheduling, patient communication, care coordination, and other services you use directly.
The bill would gradually replace the Merit-based Incentive Payment System, commonly called MIPS, with the Patient Outcome Improvement National Tabulation System, known as POINTS. The transition would take place over five years. You would still have quality standards protecting the value of your care, but physicians and other clinicians would have a larger role in developing the measurements. The intended focus would shift toward standards that have a clearer connection to patient health and clinical practice.
Several proposed measurements could be especially meaningful for you. The new approach could examine whether care helps prevent avoidable hospital stays, reduces complications from chronic conditions, lowers unnecessary medication burdens when clinically appropriate, and directs care to an appropriate setting. These are outcomes you can recognize in your daily life. If the system works as intended, your healthcare team could spend less time satisfying complicated reporting rules and more time managing your needs.
The proposal would also make changes involving alternative payment models. These models reward healthcare professionals for care quality, coordination, and cost control instead of paying only for each individual service. By holding certain participation thresholds steady for three years and allowing additional flexibility, the bill could make participation more practical for your doctors. Your experience could include better communication among providers, more attention to preventive care, and stronger follow-up after treatment, although results would depend on how each model operates.
How This Could Improve Your Care
The central issue for you isn’t simply how much Medicare pays a doctor. It is whether you can find a physician, get an appointment within a reasonable time, and continue seeing someone who understands your medical history. When independent practices face repeated financial pressure, you may encounter longer waits, fewer nearby choices, or offices that aren’t accepting new Medicare patients. Those problems can be more serious when you live in a rural or medically underserved community.
The bill would extend and increase a geographic payment protection that supports physician work in many lower-cost areas. It would also provide adjustments for locations experiencing unusually high inflation. These provisions are intended to recognize that the cost of delivering care can vary widely across the country. If you live in an affected community, stronger payment support could help a local practice continue serving Medicare patients instead of reducing hours or relocating.
Independent primary care practices would receive additional attention through a five-year demonstration program. Under the proposed hybrid approach, a qualifying practice could receive a monthly amount for each participating patient along with payment for certain services. You might receive more consistent support between office visits because the monthly payment could help cover care coordination, medication management, phone communication, and ongoing monitoring that aren’t always captured well by a traditional fee-for-service system.
The proposal could also affect you differently depending on your coverage. The Medicare Physician Fee Schedule directly concerns services paid through Original Medicare. If you have Medicare Advantage, your plan uses its own provider contracts and network rules. Still, the overall financial health of local medical practices can influence the number of doctors available in your area. The bill wouldn’t require a particular physician to accept Original Medicare or join a Medicare Advantage network.
What Happens Next
The Patients First Act has been introduced in the House of Representatives, but it isn’t current law. You won’t see immediate changes to your Medicare coverage, premiums, cost sharing, doctor payments, or provider network simply because the bill was introduced. The proposal must advance through the legislative process, pass both the House and Senate, and receive the president’s signature before its provisions can take effect.
You should also separate this bill from Medicare’s annual Physician Fee Schedule process. Federal officials have proposed physician payment changes for 2027, including lower conversion factors than those used in 2026. Those amounts aren’t final while the proposed rule is under review. The Patients First Act seeks a longer-term solution so your access to physicians doesn’t depend as heavily on temporary updates and last-minute congressional action each year.
If the bill changes during congressional review, its payment formulas, effective dates, and program details could look different in the final version. You don’t need to change your Medicare plan because of the proposal. During your next Medicare Open Enrollment period, you should continue comparing your current coverage based on confirmed premiums, drug coverage, provider participation, benefits, and out-of-pocket costs rather than possible legislative changes.
Conclusion
The Patients First Act could reshape Medicare physician payment by linking yearly updates to practice-cost inflation, revising budget-neutrality rules, simplifying quality measurement, encouraging value-based care, and supporting independent and rural practices. For you, the potential benefit is more dependable access to physicians and better continuity of care. The proposal wouldn’t guarantee that every doctor accepts Medicare, but it addresses several financial pressures that can shrink your healthcare choices.
For now, your Medicare benefits remain unchanged, and you don’t need to take action because the bill has only been introduced. You can watch for updates while continuing to confirm that your doctors accept your coverage and that your plan meets your healthcare and prescription needs. Reviewing your coverage each year can help you find a plan that better supports your healthcare needs. For more information about Medicare, please call 866-633-4427 to speak with a Senior Healthcare Solutions Medicare expert.
