MGMA 2026: Only 47% of Medical Groups Report Rising Revenue as Costs Climb

Bypaulgruensfelder
MGMA July 2, 2026
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AI-Generated Summary

Medical practice revenue growth is stalling in 2026 even as costs keep climbing. MGMA’s June 30, 2026 poll found just 47% of medical groups reporting higher year-to-date revenue versus 2025, with 36% reporting a decline—narrowing the gainers’ lead from 26 points a year ago to only 11. Meanwhile 84% report higher operating costs. Two forces drive the squeeze: the 2026 Medicare Physician Fee Schedule’s -2.5% work-RVU efficiency adjustment on 7,000+ procedural codes, and ACA marketplace erosion—effectuated enrollment fell to 19.2 million, roughly 3 million below 2025, as average deductibles jumped 37% to a record $3,786. MGMA urges practices to model Medicare impact by CPT code and refresh payer-mix projections now.

Why It Matters

For multi-site operators and practice CFOs, the margin math has shifted: with half of groups now flat or losing revenue and procedural specialties facing wRVU-driven pay cuts, Q3 is the window to rebuild Medicare and payer-mix models before Q4 accounts-receivable surprises hit.

medical practice margins medicare fee schedule 2026 payer mix ACA marketplace enrollment operating costs wRVU adjustment practice economics

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Frequently asked questions

How much did medical group revenue growth slow in 2026?

The share of medical groups reporting higher year-to-date revenue fell from 56% in 2025 to 47% in 2026, while those reporting a decline rose from 30% to 36%. The gap between gaining and losing practices narrowed from a 26-point lead to just 11 points, and the combined flat-or-falling share rose from 43% to 50%.

How does the 2026 Medicare Physician Fee Schedule affect procedural specialties?

CMS finalized a -2.5% efficiency adjustment to work RVUs and intraservice time on more than 7,000 non-time-based CPT codes, plus a 50% cut to indirect practice-expense allocation in facility settings. Because the same procedure now counts for fewer RVUs, any physician paid per wRVU sees measured productivity—and pay—drop in 2026 even for identical work, with facility cuts topping 5% for surgeons and roughly 10% on total RVUs for cardiology.

Why is ACA marketplace enrollment a financial risk for practices in 2026?

Effectuated ACA enrollment—coverage people actually paid for—came in at 19.2 million as of February 2026, nearly 4 million below January sign-ups and about 3 million under 2025’s paid total, after enhanced premium tax credits expired. Practices should watch patients who appeared insured at the time of service but had unpaid premiums, since retroactive terminations will keep hitting Q3 and Q4 accounts receivable.

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