CMS FFY 2027 Inpatient PPS Proposed Rule

CMS posted the display version of the FY 2027 IPPS proposed rule on Friday, April 10. Comments on the proposed rule posted Tuesday, April 14 are due by June 9, 2026. The

Proposed Rule can be found here:  FY 2027 IPPS Proposed Rule

Payments:

• 2.4% payment update from 3.2% minus 0.8% productivity growth

• Rural support (MDH, low-volume) expire Dec 31, 2026

• UCC DSH pool calculated to drop to $7.46BB from $7.71BB 

Mandatory Bundled Payments CJR-X Proposed:

• Nationwide, mandatory covering hips, knees, ankles
• Inpatient + Outpatient effective Oct 1, 2027

Quality:

• Adding: diabetes “excess days”, sepsis readmissions, advance care planning
• Removing process-heavy measures but shortening performance windows

FFS and MA:

• Core Measures on total Medicare performance (FFS + MA)
• Policy adjustments (like 340B) are harder to isolate
• 340B Payment mechanics are increasingly embedded in projections

What This Means for Hospital Leaders

• Risk is shifting from CMS → hospitals
• MA strategy and contracting more important than ever