What health policy issues are shaping urology care heading into 2027?

Independent urology practices continued to face downward pressure from the Medicare Physician Fee Schedule heading into 2027, according to LUGPA CEO Celeste Kirschner, CAE, MHSA. Kirschner said continuous reductions have made stability and reform tied to the Medicare Economic Index a top priority, noting that LUGPA continues to work directly with members of Congress while encouraging its physician groups to engage their own congressional representatives to help influence the outcome. Kirschner described the issue as one of the most important facing independent urology practices today.¹

Site-neutral payment reform was cited as another closely watched issue for 2027. Kirschner said she was "hoping that some of the site neutral payment reform will help keep independent practices in the community and give patients a meaningful choice" about which group and which physicians provide their care.² She said the policy could help ensure that independent urology groups remain viable options for patients navigating where to seek treatment.

Prior authorization and timely access to care were also identified as major frustrations among urologists, Kirschner said. She noted that physicians are increasingly required to handle peer-to-peer review calls, sometimes in the operating room, to secure approval for patient care, and that the burden associated with these requirements has grown substantially in recent years.

Continued advancement of innovative technology, and ensuring that Medicare and other payers keep pace with reimbursement for it, was named as another 2027 priority. Kirschner said maintaining coverage for new technologies is important for protecting patients and helping them find relief for the urologic conditions that bring them to care. She said this is particularly important as urology moves further into adopting emerging diagnostic and treatment technologies designed to expand options for patients managing complex urologic conditions.

Kirschner also raised concerns about ongoing consolidation in urology, warning that continued acquisition of independent practices by hospitals and health systems is changing the nature of the physician-patient relationship. She said "many of these smaller physician groups and smaller urology groups have been bought by hospitals and health systems," a trend that can result in local offices closing and care shifting to costlier settings, such as hospital outpatient departments or ambulatory surgery centers that may be farther from a patient's home.

Preserving patient choice and preventing further consolidation were described as priorities that tie directly back to the other 2027 policy issues, according to Kirschner. She said the overarching goal for LUGPA heading into 2027 is ensuring that independent physician practices remain available in local communities. According to Kirschner, keeping patients at the center of these decisions remains central to how LUGPA is approaching its 2027 advocacy priorities.

REFERENCES

1. CMS CY 2027 Medicare Physician Fee Schedule proposed rule and the need to protect independent urology and patient access to office-based care. LUGPA policy brief. Published August 2026. Accessed September 1, 2026. https://www.lugpa.org/cms-cy-2027-mpfs-proposed-rule-and-the-need-to-protect-independent-urology-and-patient-access-to-office-based-care

2. Holton MR. Urology health policy in 2025: big wins, ongoing battles, and what comes next. Urology Times. November 26, 2025. Accessed September 1, 2026. https://www.urologytimes.com/view/urology-health-policy-in-2025-big-wins-ongoing-battles-and-what-comes-next