Physician Groups Express Concern Over Efficiency Adjustment and New ASM Model, and Push Towards a Value-Based Model On October 31, 2025, the Centers for Medicare & Medicaid Services released its finalized Medicare Physician Fee Schedule for calendar year 2026. This article discusses the provisions contained in the MPFS final rule, as well as stakeholder reactions. On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2026, which “advances primary care management through improved quality measures, reduces waste and unnecessary use of skin substitutes, and introduces a…
-
-
The Failed “Doc Fix” The Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025. The finalized fee schedule cut payments to physicians, and Congress declined to step in and mitigate the cuts in its last-minute legislation to fund the federal government for another three months. This article discusses the provisions contained in the MPFS final rule and the failed “doc fix” legislation. On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025, aiming “to…
-
Valuation Implications The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and consequently has a strong influence on reimbursement to healthcare providers. The 2025 proposed fee changes are significant. This article focuses on the proposed fee changes and how these changes may affect valuations of healthcare practices. The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and consequently has a strong influence on reimbursement to healthcare providers. The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter and being used as…
-
Praise and Patient Access Concerns Raised from the Cuts On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024. While the finalized fee schedule cuts payments to physicians, there are a number of other (more positive) provisions in the final rule. An update to the September 2023 article on the proposed changes to the MPFS, this article explores the various changes and updates included in the MPFS final rule. On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare…
-
and Business Valuations This article delves into the key factors that shape the value of healthcare services, from cost behavior to pricing strategies, and offers insights into how valuation professionals can navigate this complex terrain. “Healthcare services are a fundamental necessity, and understanding the key drivers of value in medical practices and healthcare businesses is essential for conducting a robust valuation analysis.” This article delves into the key factors that shape the value of healthcare services, from cost behavior to pricing strategies, and offers insights into how valuation professionals can navigate this complex terrain. Healthcare services are delivered within a…
-
Clinical Services (Part I of IV) In the March/April 2017 issue of The Value Examiner, the authors gave a detailed description of how clinical services for physicians can be calculated. QuickRead is pleased to present an overview of this series, which will be presented in four parts. Please look for the more detailed analysis in The Value Examiner.