It's been a year of seismic shifts, hard-won victories, and unexpected chaos in healthcare policy. From the longest government shutdown in history to regulatory achievements, the AMGA Public Policy team has been in the trenches the whole way. In this special year-end episode of "Filibusters & Fine Print," the AMGA team counts down their top 10 accomplishments of 2025—and then debates live which achievement deserves the number one spot. Will it be protecting telehealth access during a government shutdown? Fixing Medicare's broken conversion factors? Or launching the MACRA Taskforce to reimagine physician payment for the future?

In episode #14 of Season 2 of "Filibusters & Fine Print," the AMGA team cuts through the seemingly disparate regulations of the Trump Administration and reveals four major policy themes shaping healthcare delivery: systematically shifting care to lower-cost settings, supporting Medicare Advantage as the future of Medicare, scaling mandatory alternative payment models that demonstrate measurable savings, and implementing transparency requirements that use private market rates to inform government payment. Rather than simply explaining what's changing, we explore the "why" behind these decisions—the financial logic, strategic priorities, and interconnected goals driving the administration's approach.

The 2026 Medicare Physician Fee Schedule Final Rule dropped on Halloween, and while it's not quite a horror show this year, it's far from a treat. For the first time, CMS split the conversion factor—creating separate rates of $33.5675 for qualifying APM participants (3.77% increase) and $33.4009 for non-qualifying providers (3.26% increase)—with most of the boost coming from last-minute congressional intervention. The team discussed welcome telehealth flexibilities and new remote patient monitoring codes, but concerns about the mandatory Ambulatory Specialty Model starting in 2027. The fundamental problem remains: Medicare payment rates have fallen 29% over two decades when adjusted for practice costs, and budget neutrality creates a zero-sum game among specialties. AMGA is advocating for systematic reform because the current pattern of annual crises and temporary patches is unsustainable and threatens Medicare beneficiary access to care.