MedPAC to Congress: Here’s how to rework Medicare’s misaligned incentives

Medicare's payment systems are generating the wrong incentives, and the experts who advise Congress on the program have a plan for comprehensive reform.

The Medicare Payment Advisory Commission's (MedPAC) June 2026 report to Congress opens with a sweeping critique of the three ways Medicare pays for care: traditional fee-for-service (FFS), alternative payment models (APMs), and Medicare Advantage (MA). Each approach creates financially driven distortions that inflate costs, reward volume over value, and leave primary care physicians at a structural disadvantage, according to MedPAC.

This slideshow walks through 16 MedPAC recommendations organized by payment system. Data points come from “Medicare and the Health Care Delivery System,” the June 2026 MedPAC report to Congress, and prior reporting on MedPAC meetings.