In the last two weeks, the Centers for Medicare & Medicaid Services (CMS) has begun issuing its first wave of healthcare-related final rules, including the FY 2027 Inpatient Prospective Payment System (IPPS), Inpatient Psychiatric Facilities (IPF) and Skilled Nursing Facility (SNF) regulations. Across all three, CMS made changes intended to advance digital quality measurement, promote interoperability and update quality measures (for example, COVID-19 vaccination measures are being removed). One of the most notable departures from the proposed versions is the three-month delay of the Comprehensive Care for Joint Replacement Expanded (CJR-X) model in IPPS. Most other provisions will become effective October 1, 2026, unless otherwise specified.

FY 2027 IPPS Final Rule

The IPPS final rule includes a 2.3% operating payment update, which CMS estimates could increase inpatient payments by $2.1 billion. For AHPA’s summary of the final rule, click here.

The rule finalizes the expansion of the mandatory Comprehensive Care for Joint Replacement Expanded (CJR-X) model, but delays the model’s start until January 1, 2028, to give hospitals three additional months to adjust. Other highlights from the IPPS final rule include:

• Incorporating Medicare Advantage (MA) enrollees into heart-related quality measures;
• Adding a postoperative venous thromboembolism (VTE) measure to the Inpatient Quality Reporting program;
• Giving bonus points for an electronic prior authorization measure in the Promoting Interoperability program.

FY 2027 IPF Final Rule

CMS also finalized the final rule governing IPFs. The Agency finalized updates to the IPF Quality Reporting Program (QRP), including changes to streamline reporting and improve the usefulness of quality data. To access CMS’ fact sheet, click here.

• Capping outlier payments at 20% of an IPF’s total payment (for facilities with at least 50 stays per year);
• Finalizing the new standardized IPF Patient Assessment Instrument, making IPF quality programs the first ones to support patient assessment data submission using a Fast Healthcare Interoperability Resources-based Application Programming Interface.

FY2027 SNF Final Rule
The SNF final rule includes a 2.3% payment update, anticipated to increase funding by about $880 million; updates to quality programs and discussion of future policymaking on case-mix upcoding. To access CMS’ fact sheet, click here.

• Removing the COVID-19 Vaccination Coverage Among Healthcare Personnel and the COVID-19 Vaccine: Percent of Patients/Residents Who Are Up to Date measures;
• Shortening the time frame for quarterly submission of SNF Minimum Data Set and National Healthcare Safety Network data from 4.5 months to 45 days, beginning with the FY 2029 SNF Quality Reporting Program.