If you run a primary care group, an ACO, or a Medicare Advantage plan, you’ve felt the tension: chronic disease is eating your day alive, but the “visit-based” system still rewards you for the moment, not the month.The 2026 Medicare Physician Fee Schedule (PFS) changes don’t magically fix that. But they do something important: they reinforce that CMS is not treating remote care like a side quest.

I'm the CTO at Welby Health, where we build technology for Remote Patient Monitoring and Chronic Care Management. Over the past year, we've built Markus, an internal AI assistant that helps our nurses and clinical staff with everything from patient lookups to workflow automation. Markus connects to our EHR, BigQuery, Looker, HubSpot, and a dozen other systems via MCP servers.

The 2026 Medicare Physician Fee Schedule (PFS) final rule dropped — and it’s not just another annual update. CMS is shifting how value is rewarded, how care management is reimbursed, and what operational plays practices must master to stay financially healthy in 2026 and beyond.