Families USA Submits Comments On 2026 Inpatient Prospective Payment System (IPPS) Proposed Rule

Families USA along with 30 organizations submitted comments on proposed Medicare Hospital Inpatient Prospective Payment System (IPPS) regulation for Calendar Year 2026.

The comment letter details the impacts of proposals by the Centers for Medicare & Medicaid Services (CMS) to undermine hospital requirements to improve health inequities as well as proposals to improve efforts to hold hospitals accountable for health care costs and quality.

Because Medicare sets the benchmark for how most health care services are reimbursed across all payers, engaging in the Medicare payment rulemaking process is critical to protect and improve health care payment and delivery.

Specifically, the letter addresses:

• The repeal of the Health Equity Adjustment (HEA) in the Hospital Value Based Purchasing program, which would remove a critical safeguard intended to support our nation’s most vulnerable hospitals.
• The removal of social drivers of health and commitment to health equity quality measures from the Inpatient Quality Reporting (IQR) program, which would undermine progress in social need data collection and hospital-led efforts to improve health equity.
• Updates to the mandatory Transforming Episodic Accountability (TEAM) CMMI Model, that makes important improvements to its risk adjustment methodology that strengthens accountability for health outcomes and costs.

IPPS and other Medicare payment rules hold the key to addressing the failures of our current health care payment system and should be leveraged to align the way health care is paid for with the needs of our nation’s families.