CMS finalizes 2027 hospital inpatient rule: 2.3% base increase, CJR-X model revived

CMS finalized the FY 2027 Inpatient Prospective Payment System rule. The operating payment rate increases by 2.3% for hospitals reporting quality data. The rule also revives and expands the Comprehensive Care for Joint Replacement Model. The new CJR-X model will now include hip fracture patients and shift to a regional episode target price calculation, but the start date is nudged to January 1, 2027. CMS estimates total Medicare spending on inpatient hospital services will increase by about $4.5 billion. The rule does not finalize proposed cuts to hospital disproportionate share payments. While directly impacting hospitals, independent practices should note the policy momentum toward mandatory bundled payments for orthopedic and fracture care, which could influence downstream referral and post-acute networks.