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FREE · GATED CFO BRIEF

Beyond the 2.3% Increase

FY 2027 IPPS Executive Delta & Action Table

A one-page CFO action table showing what changed from proposal to final rule, why the national payment headline is not a hospital forecast, and which decisions require facility-specific analysis.

CMS-1849-F · payment provisions generally effective October 1, 2026 · prepared by PAULA · ClinEfficiency Pro.

WHAT THE BRIEF COVERS

Final IPPS rate update

2.3% — a 3.2% market basket less a 0.9 percentage-point productivity adjustment, 0.1 point below the proposed rule.

Aggregate payments vs individual hospital impact

Aggregate IPPS payments rose to an estimated increase of approximately $2.1B even as the headline rate fell. The national total is not a hospital forecast.

LTCH PPS

A 2.3% standard-rate update with an estimated increase of approximately $54M; results vary with case mix, wage index, outliers and site-neutral cases.

MDH / low-volume expiration exposure

These payments expire December 31, 2026 under current law; approximately $0.3B if extended. A hospital-specific rural revenue cliff.

New technology add-on payments

An estimated increase of approximately $779M, about $315M above the proposal — but revenue depends on qualifying technology use, coding and documentation.

CJR-X timing and episode exposure

Begins January 1, 2028 with 90-day episodes, two-sided risk from year one, a 2% discount, and exclusion below 31 episodes.

MA data in quality measures

Finalized across specified IQR and VBP measures on staged timelines — a change in measured populations, not claim-level denial risk.

Sepsis readmissions timeline

Confidential early looks in FY 2028-2029; payment calculations begin FY 2030. No immediate FY 2027 penalty.

Electronic prior authorization

Optional bonus measure in CY 2027, mandatory in CY 2028 — implementation cost and workflow risk rather than an automatic gain.

This brief is national in scope and is not facility-specific. Facility results depend on wage index, DSH and uncompensated care, quality, outliers, case mix, rural eligibility and service mix.

UNLOCK THE BRIEF

Where should we send it?

Work email required. You will get an immediate download plus an emailed copy.

Sources: CMS FY 2027 IPPS/LTCH PPS final rule fact sheet and final-rule files; CMS CJR-X model materials; CMS-1849-F regulatory impact analysis. CJR-X amounts are CMS projections, not client outcomes. Facility-specific modeling is required. No PHI is requested or required.