Fifth Community Practice Summit Recap

Building the Movement for Independent Medicine

September 25–26, 2026 | Washington, D.C.

A Turning Point for Independent Medicine

The Fifth Community Practice Summit brought together physician leaders, specialty organizations, health policy experts, and advocates to examine the economic, policy, and competitive forces reshaping independent medicine — and to begin building a coordinated strategy for the year ahead.

The Summit came shortly after the Community Practice Coalition was honored with an ASAE Power of Associations Gold Award for bringing independent medical practices together to advance community-based, physician-led care.

The conversations reflected an important evolution for the Coalition: moving beyond individual policy fights toward a broader movement focused on demonstrating the value of independent medicine, strengthening the evidence behind that value, and ensuring physician-led practices remain a viable part of the health care system.

A Changing Health Care Landscape

The Summit opened against the backdrop of continued consolidation across physician practices. According to the latest PAI/Avalere research, 82.0% of physicians were employed by hospitals or other corporate entities as of January 1, 2026, while 63.9% of physician practices were owned by those entities. The study also found that 152,200 fewer physicians were operating independently between 2018 and 2026.

Participants emphasized that the issue is not opposition to hospitals or employed practice. Hospitals remain an essential part of the health care system, and employment is the right choice for many physicians. The broader concern is whether physician-led, community-based practices can remain a sustainable and competitive option as ownership and employment patterns continue to change.

This led to a central question for the Coalition: What does independent medicine contribute to patients and communities, and what policies are needed to allow it to compete and grow?

Stabilizing Medicare Physician Payment

Medicare physician payment was a central focus of the Summit. CMS has proposed 2027 conversion factors of $33.17 for qualifying APM participants and $32.84 for non-QPs, continuing pressure on physician practices.

Participants discussed H.R. 8163, the Provider Reimbursement Stability Act, which addresses structural issues in the Medicare Physician Fee Schedule, including budget neutrality and other factors that contribute to payment instability.

The discussion reinforced that Medicare payment stability is about more than the annual conversion factor. Payment uncertainty can affect a practice’s ability to invest in technology and staff, recruit physicians, maintain services, and continue accepting Medicare patients.

Protecting Patient Access and Specialty Care

A significant portion of the Summit focused on the connection between practice sustainability and patient access. Participants discussed how payment policy, site-of-service incentives, prior authorization, step therapy, specialty drug reimbursement, physician dispensing, and other regulatory requirements can affect how and where patients receive care.

Three federal bills provided concrete examples of these challenges.

H.R. 4299, the Protecting Patient Access to Cancer and Complex Therapies Act, addresses Medicare Part B payment for certain physician-administered drugs subject to the Medicare Drug Price Negotiation Program. The legislation would maintain ASP+6% as the Part B payment methodology for affected drugs, while requiring manufacturers to provide rebates reflecting the difference between that payment and the applicable Maximum Fair Price. The bill is intended to address potential reimbursement and acquisition challenges as negotiated drug prices begin affecting Part B therapies.

For community-based specialty practices, this issue matters because practices may need to acquire and administer high-cost therapies before receiving Medicare reimbursement. Changes in the relationship between acquisition costs, reimbursement, and negotiated prices could affect whether certain therapies can continue to be provided in community settings.

The Summit also discussed H.R. 2484, the Seniors’ Access to Critical Medications Act, which would create a targeted exception to the physician self-referral law for certain medications furnished by physician practices. The legislation addresses circumstances in which medications may be provided to patients through a physician practice, including pickup by a caregiver or delivery by mail or courier, while establishing requirements such as an ongoing physician-patient relationship and a prior face-to-face encounter.

These options can be particularly relevant for patients who have difficulty traveling to a pharmacy or require specialty medications as part of ongoing treatment. The discussion highlighted how federal regulations governing dispensing and delivery can affect both continuity of care and community practices' ability to provide services in ways that work for patients.

H.R. 3514, the Improving Seniors’ Timely Access to Care Act, was also highlighted as an important prior authorization reform measure. The legislation would expand electronic prior authorization in Medicare Advantage, establish clearer response-time requirements, improve transparency, and provide CMS with additional oversight tools. The House Ways and Means Committee advanced the legislation in July 2026, including provisions establishing a seven-day standard and 72-hour urgent response timelines.

For specialty practices, prior authorization can create significant administrative work and delay the time between a physician’s treatment decision and a patient receiving care. Participants emphasized the importance of maintaining appropriate utilization management while making the process more predictable, transparent, and responsive for physicians and patients.

Together, H.R. 4299, H.R. 2484, and H.R. 3514 illustrate three connected patient-access challenges: ensuring physicians can sustainably provide complex therapies, allowing patients to receive medications through appropriate community-based channels, and reducing administrative barriers that can delay care. The Summit reinforced the importance of policies that support timely, clinically appropriate specialty care while preserving physician judgment and independent practices' ability to serve their communities.

Confronting Consolidation and 340B

Participants explored the range of factors driving consolidation, including reimbursement pressure, administrative complexity, access to capital, contracting dynamics, and the advantages that can come with greater organizational scale.

The discussion also identified 340B as an important issue for independent physicians and competition. Participants emphasized the need for stronger evidence and real-world data to better understand how drug pricing and reimbursement policies affect independent practices, patients, and the broader health care market.

Participants identified improving the evidence base on rural and urban access, physician distribution, wait times, travel, and specialty availability as an important priority for future coalition work.

AI and the Future of Physician-Led Care

Artificial intelligence was another major focus of the Summit. Participants discussed how AI could help practices reduce administrative burdens and repetitive work, improve documentation, support prior authorization and coding, and make practice operations more efficient.

At the same time, the discussion emphasized the importance of keeping physicians at the center of clinical decision-making. A guiding principle emerging from the Summit was that AI should assist physicians, not replace physician judgment.

The Coalition will explore developing principles for responsible AI use in physician-led care, including transparency, physician oversight, privacy, cybersecurity, interoperability, and accountability.

Building the Independent Medicine Movement

The final discussions focused on how the Coalition can build a stronger and more coordinated movement heading into 2027. Priorities include:

• Build the evidence: Develop data demonstrating the value of independent medicine across access, cost, quality, outcomes, physician retention, and community impact.
• Expand the coalition: Bring additional specialties, physician organizations, and other stakeholders into the movement.
• Tell the physician story: Use real-world experiences to demonstrate how policy and market changes affect physicians and patients.
• Engage policymakers directly: Bring elected officials and policymakers into independent practices to see community-based care firsthand.
• Coordinate advocacy: Identify shared policy priorities and develop unified coalition letters and other advocacy efforts.
• Strengthen grassroots engagement: Give physicians and practices more opportunities to participate in policy discussions and advocacy.
• Develop the 2027 agenda: Continue work on Medicare payment reform, patient access, site-of-service policy, drug reimbursement, 340B, competition, and responsible AI policy.

A Common Message

The Summit also reinforced a simple framework for communicating the value of independent, physician-led care:

Better. Cheaper. Faster. Closer.

Better — physician-led care, clinical judgment, continuity, and accountability.
Cheaper — competition and the ability to provide care in appropriate, lower-cost settings.
Faster — responsive community practices that can reduce unnecessary administrative and institutional barriers.
Closer — physicians who live, practice, and invest in the communities they serve.

Looking Ahead

The Fifth Community Practice Summit provided a foundation for moving from coalition-building toward a more coordinated movement for independent medicine.

The next phase will focus on building the evidence, expanding partnerships, strengthening physician engagement, and developing common policy priorities. The goal is to ensure that physician-led, community-based care remains a meaningful and competitive option for patients and physicians as the health care system continues to evolve.