Letter to Congress Supports a 2026 Medicaid Payment Change

In a December 15, 2025, letter to Congressional leaders, The Primary Care Collaborative (PCC) and 49 national and state organizations, including the Milbank Memorial Fund, expressed support for the efficiency adjustment included in the 2026 Medicare Physician Fee Schedule.

By modestly lowering payments for services over time to reflect efficiencies gained by technology and practice improvements (except for complex services involving evaluation and management), the change will increase payments to primary care and behavioral health care, which have been historically undervalued by Medicare and other payers.

As Milbank’s immediate past president, Christopher Koller, said in a recent blog post, “This is will not close the two-and-half-fold salary gap…that creates incentives for medical students to choose specialty care professions over primary care, but the impact will grow over time.”

The letter calls on Congress to not delay or weaken the proposal, but instead “give the efficiency adjustment a chance to work.”