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.

The government shutdown is over, but what did it mean for health care and what's coming next? In this episode, the team breaks down the immediate impacts of the shutdown on Medicare and Medicaid claims processing, why healthcare providers were particularly vulnerable, and what's actually in (and notably missing from) the compromise funding deal that reopened the government. Our panel explores the political chess game that led to the shutdown, including Democrats' push for enhanced Premium Tax Credits that didn't make it into the final agreement. We discuss which critical healthcare policies got extended—including telehealth flexibilities, GPCI floors, Hospital at Home waivers, and Medicaid DSH cut delays—and what the claims reprocessing means for providers.

It's 11 PM on a Friday night, and you just received a portal notification: your test results suggest cancer. Your doctor won't be available until Monday. This is the unintended consequence of well-meaning federal rules designed to give patients faster access to their health information. In this episode, the AMGA public policy team explores the Cures Act's "information blocking" provisions and why immediate test results—delivered without context, counseling, or compassion—are causing real harm. From miscarriage notifications via text alert to cancer diagnoses released over the weekend, we examine the collision between technology and patient care. Four years after AMGA first raised concerns, we're still advocating for a middle ground that honors both patient access and quality care delivery.

Is $50 billion enough to save rural healthcare? In this episode, the AMGA team dives deep into the Rural Health Transformation Fund—a program born from the One Big Beautiful Bill Act that promises up to $500 million per state over five years. But there's a catch: the same legislation cuts almost $1 trillion from Medicaid over the next decade. Join the AMGA public policy team as we unpack what this means for rural hospitals on the brink of closure, the communities they serve, and why funding rural healthcare isn't just a rural problem. We'll explore the application requirements, the real impact of Medicaid cuts, and what Secretary Kennedy might prioritize as states compete for these critical funds.

The team sits down with incoming AMGA Chair Beth Averbeck to discuss her experience with palliative and hospice care, from both a clinical and policy perspective. Ensuring patient dignity and wishes at end of life presents a number of policy challenges, and Dr. Averbeck and the team discuss possible solutions.

In Season #2 Episode 8, the AGMA team discussed how the government shutdown is affecting healthcare. The team discussed how the shutdown is disrupting telehealth and hospital-at-home programs, how AMGA members are responding to the shutdown, and what the key political sticking points preventing a resolution are. Additional details and all episodes are available on the AMGA website.