Patients First Act Signals Commitment to Modernizing Primary Care Payment

FOR IMMEDIATE RELEASE: Wednesday, July 15, 2026

Media Contact:
pr@aafp.org

Washington, D.C. – For years, family physicians have faced a growing challenge: providing comprehensive, longitudinal care within a Medicare payment system that has failed to keep pace with rising practice costs and the evolving needs of patients. The introduction of bipartisan legislation today marks an important milestone in the effort to address these roadblocks.

The Patients First Act is a concrete step toward modernizing a payment system that has historically undervalued primary care. The legislation incorporates several priorities long championed by the American Academy of Family Physicians (AAFP) and show that meaningful payment reform may be within reach, including:

• A five-year primary care payment pilot that would provide independent physician practices with predictable, per-member-per-month payments, helping move Medicare away from an outdated fee-for-service system that rewards volume over value. By creating a more stable source of funding, the model would help physicians focus on keeping patients healthy rather than maximizing the number of billable services.
• The pilot also waives patient cost-sharing for the per-member-per-month payments, ensuring that patients can access the care they need, when they need it, without additional financial barriers.
• The pilot would create new opportunities to invest in primary care infrastructure, care coordination and patient outreach while giving physicians more time to spend with patients. Those investments have the potential to improve health outcomes and reduce costly downstream care. Importantly, the payments would be exempt from Medicare's budget neutrality requirements, ensuring investments in primary care do not result in payment cuts to other services or physician specialties.
• A permanent, inflation-based physician payment update tied to the Medicare Economic Index will address a longstanding flaw in Medicare's physician payment system. As practice costs continue to rise, physicians have faced years of inadequate and unstable payment rates that have made it increasingly difficult to care for Medicare patients, maintain staff and keep independent practices financially viable.
• The bill would implement long-overdue reforms to Medicare's budget neutrality requirements, which have created instability across the physician payment system by forcing specialties to compete against one another for limited resources.
• A new physician-led process for developing quality measures that are more clinically relevant, specialty-specific and better aligned with measuring what matters to patients. The reforms would help reduce unnecessary administrative burden while ensuring physicians are evaluated using measures that reflect the realities of clinical practice.

“Physician payments from Medicare have declined 33% between 2001 – 2025 when adjusted for inflation. Because of unstable and insufficient payment rates, family physicians report having to cap the number of Medicare beneficiaries they can see or, in some cases, stop accepting Medicare beneficiaries altogether,” said Stephanie Quinn, AAFP senior vice president for external affairs and practice experience. “We are encouraged to see Congressional efforts acknowledge that failure to reform Medicare physician payment will likely have dire consequences for our nation’s seniors and their access to care.”

Together, these reforms would reduce red tape, strengthen independent physician practices, improve patient access to care and begin correcting the historic underinvestment in primary care, which is the foundation of better health outcomes, lower costs and healthier communities.

“We applaud Representatives Joyce, Schrier and Murphy for their leadership in championing critical primary care payment reforms,” said Quinn. “Because Medicare's physician fee schedule influences payment rates across the health care system, these reforms have the potential to improve access to care for patients far beyond Medicare.”

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About the American Academy of Family Physicians
The AAFP is the largest national association of family physicians, representing 124,500 physicians and medical students. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on impactful care for people of all ages, races and genders across all medical conditions. The AAFP supports every stage of a family physician's career and provides evidence-based resources, advocacy and community to empower family medicine. To learn more, visit aafp.org. For information about health care, medical conditions and wellness, please visit the AAFP’s patient education website, familydoctor.org.