Policy uncertainty in 2026, with Anders Gilberg of MGMA

Editor’s note: This episode was recorded on January 22, 2026, before the signing of H.R. 7148, The Consolidated Appropriations Act, on February 3, 2026. For more on what the latest federal spending plan means for health care, check out 8 takeaways for practice leaders from Congress’ new funding package.

Government funding deadlines, expiring coverage subsidies and temporary policy fixes are creating real-world disruptions for physician practices — often with little warning.

Keith Reynolds, managing editor of Physicians Practice, sat down with Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association (MGMA), to talk about how recent federal policy decisions are landing inside medical groups.

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Music Credits:
Retro Rhythm by BJBeats - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 — Cold open
Why 2026 is shaping up to be another unpredictable year for health care policy.

0:22 — Intro
Austin Littrell introduces the episode, the Practice Academy note and the conversation with Anders Gilberg.

1:41 — Interview begins
Keith Reynolds welcomes Gilberg and sets the policy context.

1:44 — What breaks first during funding delays
How last-minute government decisions disrupt medical groups.

2:15 — Telehealth disruptions after shutdowns
What expired flexibilities meant for care continuity.

4:07 — Are repeated telehealth extensions real progress?
Why short-term fixes keep practices in limbo.

4:21 — A longer telehealth extension on the table
Why a 2027 extension would be a meaningful shift.

5:39 — If telehealth rules were permanent
What flexibilities matter most for patients and practices.

7:29 — The 1.0 work GPCI floor explained
Why rural physician payment protections matter.

7:46 — What happens if the floor expires
Billing chaos and reduced reimbursement in rural areas.

10:09 — PAMA lab payment cuts
What scheduled reductions would mean for in-office labs.

12:30 — The RESULTS Act
Why MGMA supports broader reform beyond delaying cuts.

12:44 — Value-based care math
Are practices backing away from Advanced APMs?

12:59 — Why incentives matter
How APM bonuses help practices transition from fee-for-service.

15:06 — P2 Management Minute
Keith Reynolds shares practical guidance for practice leaders.

15:58 — Expiring ACA subsidies
Early signs of coverage loss and financial strain.

16:20 — What practices are seeing so far
Payment plans, uncompensated care and patient access concerns.

19:13 — Direct primary care and concierge models
What policy signals may — and may not — mean.

21:27 — MGMA’s 2026 advocacy agenda
What the organization is watching closely.

21:39 — Cybersecurity and unfunded mandates
Concerns about new regulatory costs for practices.

22:55 — Final thoughts
Why policy volatility isn’t slowing down.

23:15 — Outro
Wrap-up, subscription reminder and Practice Academy note.