Back to Basics: Exploring the Building Blocks of Medicare Payment

Medicare payment policies shape everything from practice sustainability to patient access, yet many clinicians receive little formal education on how the system works. Building a strong understanding of Medicare payment fundamentals is essential to effectively advocate for long-term reform.

To that end, ACC Advocacy is developing resources to educate clinicians about the Medicare payment system, clarify policies that affect practice stability and empower ACC members to take action.

"If you're a practicing clinician, understanding how Medicare pays for care really matters," says Pascha E. Schafer, MD, FACC, chair of the Advocacy Education Workgroup taking the lead on this effort. "This knowledge gives you the power to advocate for yourself, your practice, and most importantly, your patient's ability to access the care they need."

One new resource available to cardiovascular clinicians is ACC's Medicare Payment Building Blocks video series, providing a clear, accessible overview of Medicare payment systems and how they work. The series also explains how payment reductions impact clinicians and patients alike and breaks down key concepts like budget neutrality and medical inflation. Perspectives across career stage and role in the care team are also included reinforcing the ways Medicare payment affects everyone.

"It doesn't matter what practice setting you are in or which state you may be practicing in... all of us need to be engaged in this process, advocating for our patients' care delivery...and for our team members," says Gurusher S. Panjrath, MBBS, MD, FACC.

Watch the full series.

From Education to Advocacy on the Hill

Medicare payment continues to be a key priority for the ACC, with the Congressional Affairs Team pushing for several bills under consideration in Congress. Of note, the Provider Reimbursement Stability Act, seeking to raise Medicare's budget neutrality threshold to $53 million, has doubled in co-sponsorship since its introduction.

Advocacy staff are also rallying support for the Efficiency Adjustment Reduction Act, which would delay the recently implemented "efficiency adjustment" that reduces work relative value units and intra-service time for all non-time-based codes by 2.5%.

In addition, the ACC supports the Strengthening Medicare for Patients and Providers Act, which proposes adding an automatic annual inflationary update to the Medicare Physician Fee Schedule (PFS), linking it to the Medicare Economic Index.

The College is also actively involved in broader long-term payment reform efforts, working with lawmakers and the broader medical community to introduce legislation that will improve stability in the PFS, strengthen value-based care, reduce unnecessary administrative burden and better equip clinicians to improve patient outcomes.

For more on establishing sustainable Medicare payment practices and ways to engage, visit ACC.org/MedicarePayment.

Administration Exempts Physicians From Visa Application Freeze

The U.S. Department of Homeland Security will resume processing visas for international physicians after a travel ban implemented in January froze decisions on visa extensions and work permits for citizens of 39 countries.

This exemption comes after the ACC joined the American Academy of Family Physicians and several other medical associations in a letter citing concerns over the unintended consequences of prolonged visa processing delays and indefinite adjudicative holds for medical students, resident physicians, fellows and practicing physicians from outside the U.S.

"Physicians and medical trainees are indispensable to the nation's health care infrastructure," the letter states. "Preventing them from entering the country or forcing them to abandon their training due to administrative delay harms American patients, weakens the workforce, and undermines long-standing federal health policy goals."

The College continues to advocate for legislation in Congress with the aim of supporting the clinician workforce. The H-1Bs for Physicians and the Healthcare Workforce Act, a bill recently introduced in the U.S. House, would exempt physicians, nurses and other health care professionals from a new H1-B visa petition fee established by a presidential proclamation in September 2025.

Clinical Topics: Cardiovascular Care Team, Prevention, Stress

Keywords: Cardiology Magazine, ACC Publications, CM-Jun-2026, Health Policy, Health Education, Medicare, Financial Stress, ACC Advocacy, Education