Orthopedic CEO Warns of Unstable Healthcare Reimbursement System

Allison Farmer of EmergeOrtho says Medicare and Medicaid reimbursements are not keeping up with rising costs, threatening access to care.

Published on Feb. 13, 2026

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The CEO of Durham, North Carolina-based orthopedic group EmergeOrtho, Allison Farmer, has expressed concerns about the long-term stability of the healthcare reimbursement system. Farmer says that Medicare and Medicaid reimbursements have not kept pace with rising labor and supply costs, leading to shrinking margins for providers. She warns that this could result in a decline in doctors willing to serve Medicare and Medicaid patients, limiting access to care.

Why it matters

The instability of the healthcare reimbursement system has significant implications for patients, especially those relying on government-funded programs like Medicare and Medicaid. If providers are unable to sustain their practices due to inadequate reimbursements, it could lead to a shortage of doctors willing to treat these patients, potentially creating healthcare deserts and limiting access to essential medical services.

The details

Farmer says the 2026 Physician Fee Schedule from CMS includes less than a 4% increase from 2025, while labor and supply costs have continued to rise. This has led to smaller margins for orthopedic groups like EmergeOrtho, which is now offering cash pay options for patients to complement their insurance. Farmer is urging patients to advocate for better benefits from their insurers, warning that the situation could lead to more people relying on emergency rooms for care.

  • CMS issued its final policy changes for the 2026 Physician Fee Schedule in October.
  • The North Carolina Medicaid program is tracking to turn into a dire funding situation.

The players

Allison Farmer

CEO of Durham, N.C.-based EmergeOrtho, an orthopedic group practice.

Centers for Medicare & Medicaid Services (CMS)

The federal agency that administers the Medicare program and works in partnership with state governments to administer Medicaid.

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What they’re saying

“At a federal and a state level healthcare reimbursement infrastructure is just so unstable. We're seeing all the indicators of a real future problem. I'm concerned from a Medicare standpoint, that Medicare and Medicare Advantage participants are going to see a drastic decline in the doctors that will serve them.”

— Allison Farmer, CEO, EmergeOrtho (Becker's Hospital Review)

“We have to stop wasting the billions of healthcare dollars and cut out the fraud we have now. I do think that there is a sustainable model for Medicare, Medicare Advantage and Medicaid. I think it can be sustainable for providers and hospitals because it was sustainable decades ago.”

— Allison Farmer, CEO, EmergeOrtho (Becker's Hospital Review)

What’s next

Farmer says EmergeOrtho is urging patients to advocate for better benefits from their insurance providers, as the current reimbursement system is unsustainable and could lead to a decline in doctors willing to accept Medicare and Medicaid patients.

The takeaway

The instability of the healthcare reimbursement system, driven by inadequate increases in Medicare and Medicaid payments compared to rising costs, threatens to limit access to care for patients relying on government-funded programs. Addressing this issue will require a comprehensive approach to reduce waste and fraud, while ensuring a sustainable reimbursement model for providers and hospitals.