CMS Finalizes 2027 Medicare Payment Rules, Drawing Mixed Response From Premier
Premier welcomes changes to the Medicare Shared Savings Program but warns that outpatient payment policies could deepen financial pressures on hospitals
Premier Inc. is welcoming several changes to the Medicare Shared Savings Program (MSSP) included in the Centers for Medicare & Medicaid Services’ (CMS) 2027 Physician Fee Schedule final rule, while raising concerns about separate outpatient payment policies it says could further strain hospitals financially.
The two final rules address different aspects of Medicare reimbursement and provider participation, with Premier describing progress in value-based care but warning that outpatient payment changes could reduce hospital revenue.
Shared Savings Changes Support Value-Based Care
Premier praised CMS for finalizing several policies that reflect recommendations from accountable care organizations (ACOs) and other value-based care stakeholders.
The changes are intended to strengthen the financial stability of the Medicare Shared Savings Program, reduce administrative burdens and better align incentives for coordinated, high-quality care.
Among the provisions Premier supports are expanded opportunities for shared savings, refinements to benchmarking methodologies, updated quality reporting requirements and greater flexibility for participating organizations.
Premier said the changes could help create a more sustainable program while improving participation opportunities for different types of ACOs.
The organization also highlighted provisions supporting rural communities and more practical approaches to program requirements, which could help providers facing resource and operational challenges participate in accountable care arrangements.
According to Premier, the finalized policies represent meaningful progress toward strengthening the long-term foundation of Medicare’s value-based care model.
Outpatient Payment Policies Raise Hospital Concerns
Premier expressed a significantly different view of CMS’ 2027 Medicare Hospital Outpatient Prospective Payment System final rule, warning that several provisions could increase financial pressure on hospitals and health systems.
Although the rule includes a 2.3% payment update, Premier said the increase does not adequately account for rising hospital operating costs.
The organization also raised concerns about CMS’ expansion of site-neutral payment policies, acceleration of the 340B recoupment offset and significant reductions in payment rates for 340B-acquired drugs.
Premier argues that the combined impact of these policies could offset much of the payment increase and result in lower overall reimbursement for many hospitals.
The organization warned that the changes overlook the widening gap between Medicare payments and the actual cost of delivering care.
For hospitals already managing financial and operational challenges, additional reimbursement reductions could make it more difficult to sustain services and maintain access to care.
Balancing Program Improvements With Financial Sustainability
The two final rules illustrate the challenges facing healthcare providers as CMS continues to reshape Medicare payment policies.
While changes to the Shared Savings Program may encourage broader participation in value-based care, Premier believes outpatient reimbursement policies could undermine hospital financial stability.
The organization acknowledged CMS’ continued engagement with stakeholders on the Shared Savings Program but emphasized that Medicare payment policies must also reflect the financial realities facing hospitals and health systems.
Premier’s response underscores the importance of aligning reimbursement with the cost of care while creating incentives that support quality, efficiency and long-term healthcare delivery.
