CMS finalized its 2027 outpatient and ASC payment rule Nov. 4, cutting payment for 340B-acquired drugs, expanded site-neutral payments to imaging and continuing to phase out the inpatient-only list.
Hospital groups were divided on the rule, with reactions ranging from praise for its support of patient access to criticism that it fails to account for challenges facing hospitals.
Here are three reactions to the rule:
America’s Essential Hospitals: “The 340B cuts contained in CMS’ Outpatient Prospective Payment System rule are an existential threat to essential hospitals and the patients they serve. Rather than strengthening and preserving safety net funding, CMS is instead prioritizing hospitals that do not serve the safety net and nodding to the pharmaceutical industry’s interests,” said Beth Feldpush, DrPH, senior vice president of policy and advocacy at America’s Essential Hospitals.
“These cuts are landing at a time when essential hospitals and their mission are more important than ever, as millions of people risk losing their Medicaid coverage in the coming months. Congress should ensure that CMS follows the law and preserves the 340B program, which is working as intended.”
American Hospital Association: CMS’ Medicare outpatient hospital payment rate does not adequately take into account the financial challenges facing hospitals today. These challenges are amplified for hospitals serving rural and underserved communities, many of which are already making hard decisions about how they will maintain access to healthcare services in their communities.
The AHA is also disappointed that CMS finalized another expansion of site-neutral payment policies and continued phase out of the inpatient-only list. Both policies are misguided and overlook the unique role hospital outpatient departments play in delivering care to patients in communities nationwide. Hospital outpatient departments treat sicker and more complex groups of patients than independent physician practices, including those with higher rates of disability and who are more likely to come from low-income and rural communities.
Finally, we remain deeply concerned about CMS’ continued assault on the 340B program by the reduction of reimbursement rates and accelerated clawback of funds from hospitals, both of which will further stress hospitals’ ability to care for their patients.
Federation of American Hospitals: Today’s final rule is a win for patients, taxpayers, and the hospitals that communities depend on. By bringing Medicare drug payments more in line with actual costs, this reform will lower seniors’ out-of-pocket expenses and redirect billions in Medicare dollars where they’re needed most — supporting access to care for patients served by small and rural hospitals across the country. We applaud the Administration for advancing a smarter, fairer approach to Medicare payment.
