The CY 2027 Physician Fee Schedule proposed rule includes a broad Request For Information on redesigning Medicare primary care. CMS is not yet proposing a single new payment model. Instead, it is seeking input on how to move from visit-based “sick care” toward prevention, longitudinal relationships and population health. If you wish to provide feedback, please reach out to Thomas Melton by September 1^st at Thomas.Melton@AdventHealth.com.

CMS first asks whether primary care is undervalued under the current fee schedule. It seeks feedback on distinguishing longitudinal, acute and consultative visits; revising G2211 or creating new G-codes; bundling care-management services; and simplifying overlapping chronic, principal, transitional and advanced primary care management codes. It also asks how Medicare can verify that services were actually delivered and prevent inappropriate or automated billing.

Technology is another major focus. CMS asks how clinicians are using artificial intelligence, whether it improves workflow, patient experience, quality or total cost of care, and how any productivity gains should affect payment.

Finally, CMS asks whether Accountable Care Organizations (ACOs) are ready for hybrid or fully capitated primary care payments, what services should be included, how rates should account for patient complexity and whether payments should flow through ACOs or directly to practices.

Directionally, CMS appears to favor predictable prospective payments, fewer fragmented billing codes, greater use of capitation and stronger accountability for outcomes, access and program integrity over time.