(April 6, 2026) - Last week, the Centers for Medicare & Medicaid Services released the fiscal year 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Proposed Rule. The proposal increases overall hospital payments by $1.9 billion compared to last year but decreases disproportionate share and uncompensated care payments by $564 million despite the uninsured rate estimated to increase from 8.7 percent to 9.1 percent.
Key highlights include:
- Proposes 2.4 percent payment increase.
- Expands the Comprehensive Care for Joint Replacement Model by requiring nearly all Prospective Payment System hospitals to participate in this mandatory model that would include approximately 7,000 Lower Extremity Joint Replacement cases annually.
- All acute care PPS hospitals not participating in TEAM would be required to participate in this LEJR bundled payment model to improve care coordination (approximately 37 Kansas hospitals).
- Hospitals would be held accountable for spending and quality of care during an inpatient stay or hospital outpatient procedure, and 90 days post-discharge for LEJR procedures furnished to a Medicare beneficiary.
- Certain rural, Sole Community Hospitals, and Medicare Dependent Hospitals will face a 5 percent stop loss beginning in year 1 as opposed to 20 percent symmetrical risk for all other hospitals.
- Proposed to start on Oct. 1, 2027.
- Approved medical residency programs must not discriminate, or promote or encourage discrimination, on the basis of race, color, national origin, sex, age, disability, or religion, including the use of those characteristics or intentional proxies for those characteristics as a selection criterion for employment, program participation, resource allocation, or similar activities, opportunities, or benefits. Similar requirements would also apply to approved nursing and allied health education programs and accreditors.
- Proposes to adopt three new measures to the Inpatient Quality Reporting Program:
- Excess Days in Acute Care After Hospitalization for Diabetes measure beginning with the FY 2029 payment determination.
- Hospital Harm-Postoperative Venous Thromboembolism electronic clinical quality measure beginning with the FY 2030 payment determination.
- Advance Care Planning eCQM beginning with the FY 2030 payment determination.
- Adopts five modified mortality measures and modifies three other measures related to Excess Days in Acute Care
- Removes three measures:
- Venous Thromboembolism Prophylaxis (VTE-1) eCQM.Intensive Care Unit Venous
- Thromboembolism Prophylaxis (VTE-2) eCQM.
- Discharged on Antithrombotic Therapy (STK-02) eCQM.
- Requests information on:
- Potential use of the Emergency Care Access and Timeliness eCQM in the inpatient setting.
- Potential use of the Adult Community-Onset Sepsis Standardized Mortality Ratio measure.
- Updating the scoring methodology associated with the Birthing Friendly Hospital designation.
CMS is accepting public comments on these proposals through June 9, 2026. If you have feedback, please reach out to Jaron Caffrey by May 15, to help inform the Kansas Hospital Association’s comments.