2027 Readiness Checklist
for Independent Medical Practices
Proposed Medicare payment changes, electronic prior authorization, and new Medicaid reporting rules are coming. Our free checklist below shows you how to start preparing.
What’s changing?
| Effective | Change | What's Changing | What It Means for You |
|---|---|---|---|
| January 1, 2027Proposed | Medicare rate cut | What's changingConversion factor for most clinicians will drop by 1.68% and 1.19% for qualifying APM participants as the 2026 boost expires. |
!What it means for youLess revenue per visit, making each clean claim that much more important.
|
| January 1, 2027Final Rule | Electronic prior authorization | What's changingMedicare Advantage, Medicaid, CHIP, and ACA exchange plans must support electronic prior authorization. MIPS bonus is in effect for 2027, with this becoming a MIPS requirement in 2028. |
!What it means for youFax, phone, and portal workflows can fall behind.
|
| January 2027 and later in some statesLaw | Medicaid work reporting | What's changingExpansion adults must report work or community engagement, with more frequent eligibility checks and shorter retroactive periods. |
!What it means for youMore coverage changes, eligibility denials, and self-pay balances.
|
Each of these changes is manageable with a little planning. This checklist helps you analyze the steps your practice needs to take to prepare.
How to use this checklist:
- Please start with some details about you!
- Check it: Check each item your practice does today. Not sure? Leave it blank.
- Get your score: Click the “Calculate Your Readiness” button and your results will be sent to you via the email you provided.
- Act on it: Start with your lowest section. Items marked “Proposed” may change with the final rule, expected early November of 2026.
