CMS Releases Final Medicare Inpatient And Long-term Care Hospital PPS Payment And Policy Updates For FFY 2027

The Centers for Medicare & Medicaid Services released the final federal fiscal year 2027 Medicare payment and policy updates for the Hospital Inpatient and the Long-Term Care Hospital Prospective Payment Systems. The following is a summary of the updates. 

IPPS

• Includes market basket increase of 2.3% (3.2% less 0.9% productivity adjustment)
• Estimates a net IPPS payment increase of $2.1 billion, up from $1.4 billion as proposed
• Finalizes new policy requiring that approved medical residency training programs not discriminate, or promote or encourage discrimination, on the basis of race, color, national origin, gender, age, disability or religion
• Updates IPPS quality reporting program
• Updates Medicare Promoting Interoperability Program
• Updates Medicare mandatory pay-for-program
• Expands the current mandatory CJR model into a new mandatory model, known as CJR-X
  • Most hospitals paid under the IPPS would be mandatory participants except hospitals participating in the Transforming Episode Accountability Model (TEAM) or those hospitals not paid under both the IPPS and Outpatient PPS

LTCH PPS

• Includes market basket increase of 2.3% (3.2% less 0.9% productivity adjustment)
• Estimates a net LTCH PPS payment increase of $54 million, a decrease from the proposed $55 million
• Updates LTCH quality reporting program

MHA soon will publish an issue brief with additional details.