AAOS sounds alarm on CMS Medicare proposal that drives consolidation and harms patient access to care

CMS' Proposed CY 2027 Medicare Physician Fee Schedule would destabilize physician practices and make it harder for Medicare beneficiaries to access timely musculoskeletal care

WASHINGTON, July 22, 2026 /PRNewswire/ -- The American Association of Orthopaedic Surgeons (AAOS) today expressed alarm with the Centers for Medicare & Medicaid Services' (CMS) calendar year 2027 Medicare Physician Fee Schedule (PFS) proposed rule and urges the agency urges CMS to withdraw the proposed policies that threaten patient access to high-quality musculoskeletal care.

AAOS strongly opposes the proposal and is calling on CMS to pause implementation of the new proposed payment values, maintain the current 2026 values and work with physicians to develop a more stable and sustainable approach to Medicare physician payment.

At a time when Medicare enrollment has surged to over 70 million, beneficiaries need more access to musculoskeletal care, not less. CMS' proposed rule places additional strain on physician practices already struggling with rising practice costs and years of Medicare payment instability. Orthopaedic surgeons remain committed to delivering efficient, high-quality care, but physician practices cannot absorb significant reimbursement cuts year after year without consequences for patient access.

Orthopaedic surgeons, along with small handful of other specialties, are the last frontier of independent medical practice. CMS' proposed rule threatens to push these specialties over the tipping point. After years of payment cuts to Medicare physician services generally, this rule would have irreparable damage by instituting acute cuts to orthopaedic care that will change the face of American health care indefinitely.

"CMS cannot continue to erode physician payment year after year and expect patient access to remain intact," said Wilford K. Gibson, MD, FAAOS, president of AAOS. "Private practice orthopaedic surgeons are on the front lines of delivering efficient, high-quality care in communities across the country. This proposal threatens that model, accelerates consolidation and makes it harder for surgeons to continue caring for Medicare patients. AAOS is calling on CMS to press pause, maintain the 2026 values and work with physicians on a policy that reflects the true cost and complexity of musculoskeletal care."

Payment Cuts Put Independent Practices at Risk

AAOS is particularly concerned about the cumulative impact of ongoing physician payment reductions. Orthopaedics remains one of the last major physician specialties where independent practice remains viable. As care shifts from independent physician practices to larger health systems, patients often face higher costs, fewer choices, and longer wait times. This proposal would accelerate consolidation into large health systems and permanently reshape how musculoskeletal care is delivered.

Patients Will Pay the Price Through Delayed Care and Reduced Access

Orthopaedic surgeons provide care that restores mobility, relieves pain and helps patients maintain their independence and quality of life. Medicare Physician Fee Schedule should support those outcomes by preserving patient access, rewarding efficiency and allowing physicians to make treatment decisions based on clinical expertise and the needs of individual patients, not administrative assumptions.

"This is not just a payment issue. It is a patient care issue," said Joel L. Mayerson, MD, FAAOS, FAOA, chair of the AAOS Advocacy Council. "The Proposed Rule undervalues the work required to diagnose, treat and manage complex musculoskeletal conditions, resulting in fewer physician options, longer wait times, and delayed access to care for Medicare beneficiaries. Clinical judgment must drive care decisions, not administrative policy that fails to account for what patients and surgeons face in the exam room and operating room."

AAOS will continue working with CMS, Congress, and the broader physician community to prevent these policies from being implemented.

"We will not stand by while these regulations threaten the ability of orthopaedic surgeons to care for the patients who need them," said Dr. Gibson. "CMS should listen to physicians, listen to patients and pause this rule before it does real harm."

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About AAOS
The American Association of Orthopaedic Surgeons (AAOS) is the trusted leader in advancing musculoskeletal health. With more than 39,000 members, AAOS provides education and practice management services for orthopaedic surgeons and allied health professionals. The AAOS also advocates on behalf of the orthopaedic community before federal and state legislative, regulatory and executive agencies to improve patient access to high-quality musculoskeletal care.

SOURCE American Association of Orthopaedic Surgeons