Medicare Wants to Pay Your Doctor Less in 2027. It Also Wants to Let Some Practices Waive Your Copay.
A CMS proposal issued July 14 would cut the rate Medicare pays physicians starting in 2027, once a temporary boost expires. A separate piece of the same rule would let some accountable care organizations erase your Part B copay entirely. Neither has happened. Both are proposals.
Medicare pays your doctor by a formula: a set of relative value units, multiplied by a dollar figure called the conversion factor. On July 14, CMS proposed the conversion factor for 2027 — and it's lower than what doctors are being paid right now.
The number itself is small. What's behind it is not.
Why the rate is falling
Two different conversion factors apply depending on whether a clinician qualifies as an advanced alternative payment model (APM) participant. By statute, both were due modest increases for 2027: +0.75% for qualifying APM participants, +0.25% for everyone else. CMS is also proposing an estimated +0.53% adjustment tied to changes in how it values specific services.
None of that is what's driving the cut. A separate law — the Working Families Tax Cut legislation, which CMS refers to by that name — gave doctors a one-time 2.50% boost to the conversion factor for 2026 only. That boost expires on its own at the end of this year, with or without a new rule. Net it all out, and CMS's own fact sheet says current law requires a 2.50% reduction in Medicare physician payment compared to 2026.
The proposed numbers: the qualifying-APM conversion factor would fall to $33.17, down $0.40 (-1.19%) from this year's $33.57. The non-qualifying conversion factor would fall to $32.84, down $0.56 (-1.68%) from this year's $33.40. Clinicians who don't participate in an advanced payment model — which is most of them — take the bigger cut.
What that means for patients isn't spelled out anywhere in CMS's materials, and we're not going to guess at a number CMS didn't publish. What's on the record: physician groups have warned for years that repeated cuts to the conversion factor make it harder to keep accepting new Medicare patients, particularly in primary care and rural practices where margins are already thin. Whether this specific cut changes access to care is something CMS's fact sheets simply don't address.
The part aimed at coordinated care
The same rule proposes real changes to the Medicare Shared Savings Program — the ACO system where groups of doctors and hospitals take on financial risk in exchange for a share of what they save Medicare. CMS says the program has now generated savings for the Medicare Trust Funds for eight straight performance years. In performance year 2024, CMS reports that 75% of the 476 participating ACOs earned shared savings payments totaling $4.1 billion, and that the program produced roughly $2.5 billion in net savings for the Trust Funds even after those payments went out.
The proposal would raise the shared-savings rate for one participation track from 50% to 60%, adjust how regional cost benchmarks get calculated, and — the piece that reaches patients directly — let approved ACOs reduce or eliminate Medicare Part B cost-sharing for certain items and services, for beneficiaries the ACO identifies, starting as early as the second quarter of 2027. CMS says the idea is modeled on what it's already seen work in the ACO REACH model. It would not apply to durable medical equipment, prosthetics, orthotics, supplies, or prescription drugs, and it only applies if your specific doctor's practice is part of an ACO that applies for and receives approval to do it. It is not an automatic, system-wide waiver.
CMS Administrator Dr. Mehmet Oz called the package "some of the most significant Medicare reforms in recent years," aimed at making it "easier for clinicians to focus on prevention, improve coordination for patients, and ensure Medicare rewards better outcomes rather than more services." CMS Deputy Administrator John Brooks framed the goal more simply: "deliver better outcomes for patients by appropriately incentivizing providers, improving quality measurement, and reducing administrative burden."
What we could not verify
CMS's own fact sheet states there is a 60-day public comment period on the proposed rule — and then leaves the closing date as an unfilled placeholder: "The 60-day comment period closes on Month XX, 2026." We could not find the actual date anywhere in CMS's published materials as of this writing. Comments can be submitted at regulations.gov under file code CMS-1848-P once the rule is formally published in the Federal Register; we're not going to invent a closing date CMS itself hasn't posted.
We also can't tell you, and CMS doesn't say, how many Medicare beneficiaries would actually see a copay reduction if the ACO cost-sharing proposal is finalized. That depends on how many ACOs apply, how many CMS approves, and which services each one picks — none of which exists yet, because the rule itself doesn't exist yet.
What This Means for You
If you're on Medicare: nothing changes today. If your doctor's practice is part of an ACO, it's worth asking whether they plan to apply for the Part B cost-sharing waiver once the rule is final — that's a real, if narrow, path to a lower bill starting sometime in 2027. If you don't know whether your doctor participates in an ACO, that's a reasonable question to ask at your next visit.
If your doctor's office mentions a "Medicare pay cut": this is what they're referring to. It's a proposed reduction of roughly 1.2% to 1.7% to the base payment rate, not yet finalized, and separate from any specific service getting more or less expensive.
Sources
- CMS, "CMS Proposes Transformational Medicare Reforms to Expand Accountable Care, Modernize Physician Payment, and Shift from Sick Care to Healthcare" — press release, July 14, 2026
- CMS, Fact Sheet: "Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule" — July 14, 2026
- CMS, Fact Sheet: "CY 2027 PFS Proposed Rule (CMS-1848-P) — Medicare Shared Savings Program Proposals" — July 14, 2026
Disclaimer: This article is news and general information only, not medical, financial, or legal advice. CMS-1848-P is a proposed rule as of publication and has not been finalized; every figure here may change before a final rule is issued.