Drs. Joyce, Murphy, and Schrier Introduce Bipartisan Patients First Act
July 15, 2026
Comprehensive Medicare Access and CHIP Reauthorization Act (MACRA) Reform Legislation Will Keep Patients Healthy, Preserve Competition, and Deliver Affordability
WASHINGTON, DC - Today, Reps. John Joyce, M.D. (PA-13), Greg Murphy, M.D. (NC-03), and Kim Schrier, M.D. (WA-08), respective chairs of the GOP and Democratic Doctors Caucuses, introduced the bipartisan Patients First Act–comprehensive Medicare Access and CHIP Reauthorization Act (MACRA) reform legislation.
The Patients First Act is necessary to keep patients healthy, preserve competition, and deliver affordability. The legislation will reform the Medicare physician fee schedule, improving seniors’ access to care by strengthening the incentives for independent practice and reversing decades of consolidation that drives up the cost of care, especially in rural and underserved areas.
"The House of Medicine is at a crossroads. We can maintain the status quo that rewards more costly, less personalized care, or we can put our heads together to build a modern framework that addresses the challenges that impede physicians’ ability to care for their patients," said Congressman John Joyce, M.D. (PA-13). "We often talk about expanding access to high-quality care, but without meaningful Medicare reimbursement reform, that mission becomes nearly impossible to achieve. Putting patients ahead of politics, we worked together to develop this comprehensive legislation to address a system that has for far too long undermined patient access to affordable, physician driven care within their communities. We can and must do better. This proposal deserves serious consideration because the future of patient care, the strength of our physician workforce, and the survival of independent practice all hinge on whether we choose to act rather than accept inaction. "
"As a practicing urologist for more than 30 years, I've seen firsthand the challenges physicians face in keeping their doors open while providing the highest quality care for their patients," said Congressman Greg Murphy, M.D. (NC-03). "Our current Medicare physician payment system is unsustainable. It has fueled consolidation, increased administrative burdens, and made it harder for independent physicians in rural communities to continue serving the patients who rely on them. The bipartisan Patients First Act delivers long-overdue reforms that strengthen independent practices, invest in primary care, and ensure physicians can spend more time caring for patients instead of navigating bureaucracy. When physicians succeed, patients receive better care, and that's exactly what this legislation is designed to achieve."
"Our nation is in a primary care crisis, and if we don’t act swiftly to reform the system, patients will lose access to care, costs will rise, and physician practices will continue to close,” said Congresswoman Dr. Kim Schrier, M.D. (WA-08). “Consolidation in our healthcare system is forcing small, independent physicians to sell their practices to corporate entities, decreasing choice and competition, and increasing costs for patients without delivering better quality. This bill gives stability to independent practices, reduces red tape and burdensome paperwork, and invests in primary care. By introducing the Patients First Act, we are addressing the challenges physicians face with a commonsense, bipartisan solution. Patients deserve better, and this bill delivers on that promise."
KEY BACKGROUND:
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is bipartisan legislation signed into law on April 16, 2015.
MACRA:
- Repealed the SGR methodology for determining updates to the Medicare physician fee schedule (MPFS)
- Established a merit-based incentive payment system (MIPS) to consolidate and replace several existing incentive programs
- Incentivized the development of, and participation in, alternative payment models (APMs)
In a rapidly consolidating health care landscape, nearly seventy percent of medical practices nationwide are owned by hospitals or other corporations. One in ten physicians works for UnitedHealth or an affiliate. Running an independent physician practice is costly, with physicians increasingly forced to either close their doors or sell their practices due to low reimbursement rates and increasing practice expenses. When physician practices are acquired, costs go up for patients.
Not only is care becoming more consolidated and costly, America is also facing a primary care crisis. Primary care providers foster a life-long relationship with patients and provide disease prevention, treatment and management. Today, less than five cents of every Medicare dollar go to primary care, even though it accounts for more than half of all physician visits. It’s no coincidence that more than 100 million Americans don’t have access to regular primary care.
THE PATIENTS FIRST ACT:
- Ties physician reimbursement to an inflationary measure.
- Establishes a primary care hybrid payment pilot program that pays PCPs a per-member-per-month payment along with regular services, better capturing the work PCPs do.
- Establishes the POINTS program, which creates a physician and clinician-led task force at CMS to develop quality metrics that are streamlined and reduce administrative burden.
- Freezes A-APM participation thresholds for three years and creates notice and comment periods for CMMI mandatory models.
- Increases the budget neutrality threshold from $20 million to $54.3 million.
Click HERE for more information on the Patients First Act.
Issues:Health
