The Centers for Medicare and Medicaid Services (CMS) on April 10 released the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule, with comments due June 9. The CMS is proposing to increase the payment rates by 2.4% for items and services paid under IPPS for FY 2027, reflecting a projected FY 2027 hospital market basket percentage increase of 3.2%, reduced by a 0.8 percentage point productivity adjustment. The agency proposed total uncompensated care-based payments equal to $7.46 billion (a decrease of $250 million from FY 2026) and empirically justified disproportionate share hospital payments equal to $3.83 billion in FY 2027.
For Graduate Medical Education (GME) updates, the rule proposes modifications to the criteria for new residency programs based on a determination of at least 90% of residents having no previous training experience in the specialty, with certain exceptions for matched and displaced residents and small programs accredited for 16 or fewer residents. There are also proposed modifications to the criteria for approved programs. The CMS also announced Section 5506 slot redistributions — Rounds 27 and 28 — from the closure of Delaware County Memorial Hospital and Crozer-Chester Medical Center, both in Pennsylvania.
The rule proposes several changes to the inpatient quality reporting and performance programs, including new measure adoptions, measure modifications, and measure removals over varying periods depending on a given program. The CMS also seeks feedback on several requests for information on quality measurement topics. Finally, the rule proposes changes to the mandatory Transforming Episode Accountability Model, which began earlier this year, and to establish a national successor model to the Comprehensive Care for Joint Replacement (CJR) model that ended in 2024. The proposed national model would be called CJR-Expanded and would begin FY 2028, if finalized.