Hospitals see a small pay raise from Medicare
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Hospitals are due to receive $4 billion more from Medicare under a proposed fiscal 2026 inpatient payment rule the Trump administration released on Friday.
Why it matters: The 2.4% increase comes after the Trump administration finalized a larger pay boost to Medicare Advantage plans that hospitals say are likelier to require preapprovals, deny claims and pay less than what providers bill for.
The big picture: While some of the biggest hospital chains have seen their fortunes rebound since the pandemic, smaller rural facilities are struggling to keep their doors open.
- The industry also could see its financial outlook change from federal cutbacks to Medicaid.
The proposed rule calls for $1.5 billion more in uncompensated care payments to hospitals that see a disproportionate share of poor and uninsured patients.
Yes, but: The Centers for Medicare and Medicaid Services said it's proposing to drop quality measures for health equity, COVID-19 vaccination coverage of health care workers and screening for social determinants of health. Under the current system, hospitals can see their payments reduced for falling short on such benchmarks.
- Administrators are also requesting input on enhancing nutrition and physical activity "to promote better wellness through quality measurement and other initiatives."
- They are also seeking public comment on opportunities streamline regulations and "reduce burdens on those participating in the Medicare program."
What they're saying: "We are very concerned that this update will hurt our ability to care for our communities," the American Hospital Association said in a statement.
- "Indeed, many hospitals across the country, especially those in rural and underserved communities, already operate under unsustainable financial situations, including negative margins," the group said.
