Senate Finance Committee Chair Ron Wyden is reviving talk of updating the way Medicare pays physicians and putting an end to the yearly ritual of doctors pressing Congress to avert scheduled pay cuts.

Why it matters: An overhaul could incentivize more coordination of care and peg payments to outcomes, not just the quantity of services provided, Peter reports.

• But that's been a goal for years, and past Congresses have struggled to make lasting changes.

Driving the news: The Finance Committee will hold a Thursday hearing on physician pay and how it affects caring for patients with chronic conditions — a pet cause of Wyden's.

• Congress used last month's spending deal to partially offset a 3.37% cut to Medicare payments to doctors, but physician groups are pressing for more, noting that they were forced to eat a 2% Medicare pay reduction last year.

What they're saying: "I'm trying to jumpstart a bigger debate about doctors' pay," Wyden told Axios. "You know, because every year you go through, 'Oh we need to do something, we need to do something.'"

• "Doctors come and make a good case that they're having problems attracting people to the field," he added. "People back here say, 'Yup, gotta do something,' and then it just kind of goes on."

Wyden wants to build on a 2018 law he worked on with the late Sen. Orrin Hatch to improve how Medicare pays for chronic care.

• Part of that is extending ideas like reduced cost-sharing for certain high-value services into traditional fee-for-service Medicare.
• Thursday's witnesses include officials from the American College of Surgeons and American Academy of Family Physicians, whose prepared testimony calls for ideas like increasing physician payments for inflation and better incentivizing participation in alternative payment models.

What's next: Any major overhaul of physician payments faces long odds. The Finance Committee may follow up with discussion drafts.

• In the House, some prominent physician-lawmakers who are retiring like Reps. Michael Burgess and Larry Bucshon could try to make passage of Medicare doctor pay reforms a legacy issue.

Reps. Brian Fitzpatrick and Neal Dunn want to expand the number of drugs Medicare covers for home infusion, to address what they say is a piece of unfinished business from the 21st Century Cures Act.

Why it matters: Lawmakers and the Biden administration generally want to expand in-home care, but there are concerns over how much of the cost would be passed on to Medicare beneficiaries.

What's inside: The Joe Fiandra Access to Home Infusion Act, named after a deceased constituent of Fitzpatrick's, would add drugs to Medicare's home infusion benefit by establishing them as suitable for delivery through a pump and requiring patients to also receive regular nursing services.

• CBO projects it would save $139 million over a decade, primarily because beneficiaries would bear a larger share of the cost of infusions that occur at home.
• The sponsors say it would clarify that the home infusion benefit, which was passed as part of 21st Century Cures, is not limited to drugs that are self-administered. That could open coverage to more treatments for rare diseases.

Yes, but: CBO notes that no one knows just how many drugs would qualify for coverage under the bill, making cost projections uncertain.

The House Energy and Commerce Committee unanimously advanced the bill in December, setting it up for possible action in a lame-duck session.

• It is one of several measures addressing Medicare home infusion services.

What we're watching: Where home infusion stacks up in the raft of health care priorities Congress has punted to the lame duck.