The Medicare Payment Advisory Commission (MedPAC) released its March 2026 Report to Congress, recommending a 0.5% increase in physician payments above current law. MedPAC evaluates Medicare payment adequacy and makes policy recommendations for 2027. MedPAC is an independent nonpartisan agency that advises Congress on Medicare policy, including provider payments.
The following items are relevant to radiation oncology: 

Physician and other health professional services (Chapter 4)

MedPAC found that overall indicators remain positive despite ongoing concerns about payment levels. The number of clinicians billing under Medicare has grown steadily, and access to care for beneficiaries remains strong, with most beneficiaries reporting that access to clinician services is comparable to or better than for privately insured individuals. At the same time, the composition of the workforce is shifting, with rapid growth in advanced practice registered nurses (APRNs) and physician assistants (PAs), while the number of primary care physicians has slightly declined, raising longer-term concerns about primary care capacity. Service use per beneficiary has increased, particularly for evaluation and management visits, contributing to higher spending growth.

MedPAC found that quality of care has remained generally stable and that clinicians continue to participate in Medicare at very high rates, indicating continued access for beneficiaries. The Report concludes that payment adequacy is sufficient and recommends a modest payment update for 2027. MedPAC recommends Congress increase physician and other health professional payment rates by 0.5 percentage points above current law to help maintain access and address cost pressures.

Hospital inpatient and outpatient services (Chapter 3)

MedPAC found that while utilization continues to shift from inpatient to outpatient settings, overall hospital spending growth is largely driven by increased service intensity and outpatient volume. Medicare margins for hospitals remain negative, indicating payments do not fully cover costs; however, hospitals maintain positive all-payer margins, suggesting financial stability overall. MedPAC concludes that beneficiary access to care remains stable, quality outcomes are mixed but improving in some areas, and hospitals continue to have adequate access to capital.

The Report highlights ongoing policy concerns, including higher payments for services delivered in hospital outpatient departments compared to physician offices, which incentivize site-of-care shifts and increase spending, as well as continued financial pressures on rural hospitals. Based on these findings, MedPAC’s recommendation for Congress for 2027 is to update the 2026 Medicare base payment rates for general acute care hospitals by the amount specified in current law and implement the Medicare Safety-Net Index (MSNI) described in the March 2023 Report, with an additional $1 billion added to the MSNI pool.