The Patients First Act of 2026 restructures Medicare's physician payment system through multiple reforms spanning 2027 to 2032. It establishes a voluntary hybrid payment model from 2027-2031 allowing qualified, physician-owned primary care practices to receive monthly payments per patient rather than per-service fees, while introducing a new "Patient Outcome Improvement National Tabulation System" (POINTS) in 2032 to replace the current MIPS program with enhanced focus on care efficiency metrics like reducing avoidable hospitalizations and medication burden. The bill creates a 25-member Quality Reform Task Force to recommend performance measures and requires Medicare claims data access for clinical registries beginning in 2027 to support quality improvement research. Additionally, the legislation caps annual physician payment rate changes at 2.5 percent starting in 2027 to ensure predictability, requires formal rulemaking procedures for Center for Medicare & Medicaid Innovation models, and provides early-adoption incentives for physicians who voluntarily report on new quality measures beginning in 2027, affecting how Medicare pays physicians and evaluates their performance over the coming years.