Most Doctors Get A Medicare Pay Raise, But Some Specialists Will Get A Pay Cut
As Modern Healthcare reported, most primary care physicians who treat Medicare beneficiaries will receive a 2.5% raise next year under a new regulation issued Friday. However, there will be a 2.5% cut next year to payments for services like radiology and gastroenterology that are based on more than time spent delivering the service, Axios reported.
Modern Healthcare:
Medicare Physician Pay To Rise 2.5% In 2026 Under CMS Final Rule
Doctors who treat Medicare beneficiaries are getting a 2.5% raise next year under a regulation the Centers for Medicare and Medicaid Services issued Friday. The 2026 Medicare Physician Fee Schedule final rule implements provisions from the tax law President Donald Trump enacted in July, which mandated a pay hike and reversed a multiyear trend of reimbursement cuts. CMS also spells out its plans for an “efficiency adjuster” that will reduce some payments, a lower back pain and heart failure payment model, and new flexibilities for telehealth coverage. (Early, 10/31)
Axios:
Medicare Finalizes Policy To Cut Doctor Pay For Specialty Services
The Trump administration on Friday finalized a controversial plan to reevaluate how Medicare calculates doctor payments that will result in lower rates for specialty services. Medicare will implement a 2.5% cut next year to payments for services like radiology and gastroenterology that are based on more than time spent delivering the service. (Goldman, 11/3)
More health industry updates —
The Harvard Crimson:
Authorities Investigating Explosion At Harvard Medical School, Believed To Be Intentional
A device exploded inside the Goldenson Building in Harvard’s Longwood medical campus early Saturday morning, according to a message from the Harvard University Police Department to University affiliates. An officer who responded shortly before 3 a.m. observed two individuals fleeing the building, according to the email sent by HUPD spokesperson Steven G. Catalano this afternoon. (Josephy and Shugard, 11/2)
Modern Healthcare:
WISeR Model Adding Medicare Prior Authorization Worries Providers
An artificial intelligence-powered initiative to test prior authorizations in fee-for-service Medicare needs to be delayed, healthcare providers say. The Wasteful and Inappropriate Service Reduction, or WISeR, Model is scheduled to take effect in six states on Jan. 1. But amid a government shutdown that has lingered for a month, key details remain unknown, including which technology companies will operate the AI and machine learning tools that will manage prior authorizations for Medicare. (Early, 10/31)
Stat:
Med First Says Medical AI Revenue Is Helping It Open More Clinics
Wes Edwards, chief financial officer of primary and urgent care chain Med First, pulls no punches when it comes to money and health care. “We’re a for-profit entity that believes that the more margin that we’re able to make, the more patients we’re able to serve,” he told STAT. (Trang, 11/3)
Modern Healthcare:
CHS To Sell Stake In Tennova Hospital To VUMC
Community Health Systems has signed a definitive agreement to sell its remaining ownership in two joint ventures to Vanderbilt University Medical Center for $600 million. The joint ventures own and operate a 270-bed hospital in Clarksville, Tennessee, as well as ancillary businesses. Nashville, Tennessee-based VUMC owns a 20% minority stake in the joint ventures and would buy the remaining interests through the transaction, according to a Thursday news release. (Eastabrook, 10/31)
Modern Healthcare:
How MUSC Health, Esperanza Benefit From Telehealth Strategies
Health systems are strategizing around the future of telehealth care, despite the pause in reimbursement for Medicare patients. As a result of the government shutdown, Medicare is largely not paying for telehealth care except for behavioral health visits. This has led some providers to scale back or shut down services. Others plan to continue submitting claims for care and are optimistic they’ll be reimbursed down the line. (Perna, 10/31)
Axios:
Rural Health Providers Worry About Losing Money Race
There's about to be a lot of competition for the $50 billion rural health fund that was created to minimize the impact of the GOP budget law — and rural providers worry they're going to get squeezed out. The money could provide a lifeline as rural providers across the country struggle to keep facilities open under the nearly $1 trillion in Medicaid cuts anticipated from the budget bill. (Goldman, 11/3)
Fierce Healthcare:
BlackDoctor, Pharma Partners Unveil Generational Health
BlackDoctor.org, a health platform that reaches 20 million people, launched a new initiative, Generational Health, that aims to connect science and culture to improve the health and longevity of Black families. The initiative, unveiled at the 2025 American Public Health Association (APHA) conference in Washington D.C. on Sunday, represents a sustained national effort to "reimagine how health is understood, taught and passed down," according to the organization. (Landi, 11/2)
Stat:
AHA Scientific Sessions: What To Expect At New Orleans Conference
Later this week, physicians, researchers, patients, and patient advocates will gather in New Orleans for the scientific sessions of the American Heart Association, where they will hear about new ways to address cardiovascular disease, the leading cause of death in the United States. (Cooney, 11/3)
