Valued Voice

On July 31, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that increases inpatient payment rates by a net 2.6% in FY 2026, slightly above what it had proposed. WHA expressed concerns in its comment letter that recent payment rules had not been keeping up with overall inflationary cost increases for hospitals. 

The agency also finalized several proposed changes to quality programs, including:

• Removing four measures from the inpatient quality reporting program (IQR) focused on health equity as well as the COVID-19 vaccination measure for health care workers.
  • Also shortening performance periods and lowering submission thresholds for hybrid measures in the IQR.
• Adding Medicare Advantage patients in the calculation of certain claims-based quality measures in the IQR and Hospital Readmissions Reduction Program (HRRP).
• Maintaining a minimum 180-day EHR reporting period in the promoting interoperability program and requiring "yes" attestations both Security Risk Analysis and SAFER Guides. This will add an optional Trusted Exchange Framework Common Agreement (TEFCA) bonus measure, beginning in CY 2026.
• Making minor changes to the mandatory Transforming Episode Accountability (TEAM) model establishing bundled payments for five surgical procedures, slated to start Jan. 1, 2026.

You can read CMS's summary and find the full published rule here.