CMS has released the FFY 2027 Medicare Inpatient Prospective Payment System (IPPS) Final Rule and CMS is placing greater emphasis on Medicare Advantage, electronic quality reporting, bundled payments, and technology-driven reimbursement.
- CMS finalized a 2.3% operating payment update for FY 2027, down from 2.6% last year and down from the proposed 2.4%.
- Medicare Advantage Beneficiaries continue to be incorporated into additional quality programs and performance measures.
- CMS finalized a new 30-day sepsis readmission measure for the Hospital Readmissions Reduction Program. Payment implications will not begin immediately. The implementation period allows time to evaluate sepsis documentation, discharge planning, care transitions, and post-acute care.
- $779 million is estimated in additional New Technology Add-on Payments (NTAPs).
- Additional interoperability requirements were finalized, including the phased implementation of electronic prior authorization. While the initial implementation provides flexibility, mandatory reporting is approaching.
- There are new quality measures while retiring several older process-oriented measures. Movement continues toward outcome measures, electronic clinical quality measures (eCQMs), and more automated reporting through the electronic health record.
- CMS finalized the nationwide expansion of the Comprehensive Care for Joint Replacement model (CJR-X), reinforcing movement toward episode-based reimbursement. Bundled-payment models appear to remain an important component of payment reform.
- The future of the Medicare-Dependent Hospital (MDH) program and enhanced Low-Volume Hospital adjustment continues to depend on Congressional action.
The IPPS Final Rule can be found here: IPPS Final Rule