Doctors who treat Medicare beneficiaries are in for leaner times, judging from the program’s recently announced reimbursement update. And it will be those beneficiaries who will pay the price.

The proposed changes to Medicare’s “fee schedule” would technically increase doctor reimbursement by 2.5%. But the government is also proposing to cut payments for many procedures with a 2.5% “efficiency adjustment.” This, together with several other changes to how doctor pay is calculated, will result in cuts in reimbursement for many physicians.