Each year, the Centers for Medicare & Medicaid Services (CMS) adjusts the rates it pays doctors for treating Medicare patients. For independent physicians, these reductions mean tighter budgets and tougher choices. In 2025, physician reimbursement is set to decrease yet again. But it's not just CMS driving these changes—commercial insurers are following CMS's lead, turning the ripple effect of these cuts into a wave that's reshaping health care across the country. This constant downward pressure is more than just an inconvenience for doctors; it's a growing problem for every patient, family, and community.

Physicians rely on CMS payments to contribute to their fixed costs, but they also depend on private insurance reimbursements to keep the practice running. CMS sets a "fee schedule" for each medical service, which dictates how much doctors are paid for Medicare patients. However, many private insurers follow this fee schedule too, effectively outsourcing their decision-making to CMS. So, when CMS cuts payments, insurers often slash their rates as well, paying doctors even less. This isn't just a policy decision; it's an industry-wide shift that leaves doctors scrambling to cover the cost of providing care to all patients, not just those with Medicare. Over time, this practice has squeezed independent practices to the breaking point, making it difficult—if not impossible—for small practices to survive, particularly in rural areas.