The Centers for Medicare and Medicaid Services issued final rules for the hospice payment rate, the Medicare inpatient psychiatric facility prospective payment system (IPF PPS), and related quality reporting programs for fiscal year (FY) 2026.
CMS will update the IPF PPS payment rate by 2.5%, based on the 2021 market basket increase of 3.2% and reduced by an across-the-board 0.7% productivity adjustment. In the IPF PPS fact sheet, the agency explains that it will increase penalties for failure to participate in the quality reporting program (IPFQR Program) and will modify the reporting period of the 30-day Risk-Standardized All-Cause Emergency Department Visit Following an Inpatient Psychiatric Facility Discharge measure from a one year reporting period to a two year reporting period.
The payment boost will result in an increase of $70 million to psychiatric facilities, Behavioral Health Business reports. It also eliminates the quality reporting metrics for “Facility Commitment to Health Equity; COVID-19 Vaccination Coverage among Health Care Personnel; Screening for Social Drivers of Health; and Screen Positive Rate for Social Drivers of Health.”
Hospices will receive a base payment increase of 2.6% under the new hospice payment rate, which is up from the 2.4% initially proposed in April, Home Health Care News reports. Though the aggregate represents a $750 million increase in hospice spending, industry professionals are calling the boost “insufficient.” From Dr. Steve Landers, CEO of the National Alliance for Care at Home:
While the finalized 2.6% payment update is still insufficient for providers that face persistent inflationary forces amid an ongoing nationwide healthcare workforce crisis, we recognize CMS’s incorporation of Alliance feedback to help streamline regulatory requirements.
The full hospice payment update can be reviewed at the CMS Fact Sheet.
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