ASA endorses Patient First Act of 2026

The American Society of Anesthesiologists (ASA) has “applauded” the introduction of the bipartisan Patients First Act of 2026, which it calls a “comprehensive” Medicare physician payment reform proposal that would “help stabilize Medicare physician practices, strengthen quality measurement, and support safer, more reliable care for Medicare beneficiaries.”

“This legislation represents a serious and constructive effort to address longstanding weaknesses in the Medicare physician payment system,” stated ASA President Patrick Giam, MD, FASA. “Most importantly, it would replace inadequate and unpredictable payment updates with annual updates tied to the Medicare Economic Index, helping physician practices keep pace with the rising costs of delivering high-quality care to Medicare patients.”

ASA stated that proposed reforms in the bill are “intended to make Medicare payment more stable, predictable, and responsive to clinical practice.” In particular:

• “It would modernize budget-neutrality requirements and establish a mechanism to correct inaccurate CMS utilization estimates.”
• It would “replace the burdensome Merit-based Incentive Payment System with a new performance program, preserve low-volume exemptions, and establish what, on its face, appears to be a robust physician-led process for developing more clinically relevant and specialty-specific quality measures.”
• “The essential role of Qualified Clinical Data Registries (QCDRs), including ASA's National Anesthesia Clinical Outcomes Registry (NACOR), would continue under the Patients First Act.”
• “ASA also welcomes provisions designed to strengthen alternative payment models and improve the transparency and stability of Medicare Innovation Center initiatives. By maintaining current participation thresholds, providing greater flexibility for physicians entering advanced payment models, and requiring formal rulemaking before major models are changed or terminated, the Patients First Act would give practices greater confidence to invest in new approaches to care delivery.”

“ASA did not support the original Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 because of our concerns about its payment incentive structure,” stated Dr. Giam. “Experience has validated those concerns, and we are hopeful this legislation will provide a meaningful reset of Medicare’s physician payment and quality programs… The bill is not perfect, but it provides a strong foundation for addressing the financial and administrative pressures facing our members’ practices. ASA looks forward to working with the bipartisan Doctors Caucuses and other stakeholders to refine and advance these important reforms.”

“This legislation represents a serious and constructive effort to address longstanding weaknesses in the Medicare physician payment system,” stated ASA President Patrick Giam, MD, FASA.