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CMS Proposes 2.4% Medicare Payment Hike for 2026

7/18/2025

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Summary

CMS Medicare Payment Increase

CMS plans a 2.4% increase in Medicare outpatient payment rates for 2026 to improve access and lower costs.
Proposed changes aim to expand site-neutral payments and eliminate 285 procedures from the inpatient-only list.
New transparency rules will require hospitals to disclose negotiated charges and pricing distributions.
Physician groups raise concerns about temporary reimbursement adjustments and the removal of health screenings related to social determinants.

Summary

Employers Raise Healthcare Costs

A Mercer survey indicates that over 50% of large US employers will raise healthcare costs in 2026 due to specialty drug expenses.
51% of employers with 500+ workers plan to increase deductibles and out-of-pocket maximums, up from 45% in 2025.
Employers are seeking alternatives to traditional pharmacy benefit managers amid rising drug costs.
Mental health services and support for child and elder care are expanding despite financial concerns.

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CMS Medicare Payment Increase

CMS plans a 2.4% increase in Medicare outpatient payment rates for 2026 to improve access and lower costs.
Proposed changes aim to expand site-neutral payments and eliminate 285 procedures from the inpatient-only list.
New transparency rules will require hospitals to disclose negotiated charges and pricing distributions.
Physician groups raise concerns about temporary reimbursement adjustments and the removal of health screenings related to social determinants.

1 / 2