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Healthcare Facilities & Managed Care "CY27 Outpatient PPS & ASC Proposed..."
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Healthcare Facilities & Managed Care "CY27 Outpatient PPS & ASC Proposed..."
Global Research
3 July 2026ab
Healthcare Facilities & Managed Care Equities
AmericasCY27 Outpatient PPS & ASC Proposed Rule
Increases Rates by 2.4%; For-Profit Healthcare Providers
OPPS Effective Rate Update of 7.8% AJAnalystRice
aj.rice@ubs.com
+1-212-713 4299
CY27 OPPS and ASC Rate up 2.4% Joseph Overman
Associate Analyst
On the morning of July 2nd, CMS issued a proposed rule which would raise calendar joseph.overman@ubs.com
year 2027 outpatient prospective payment system (OPPS) and ambulatory surgery +1-212-882 0086
center (ASC) rates by 2.4%. The update is based on a projected 3.2% hospital market
James Kurek
basket percentage increase, reduced by a 0.8% productivity adjustment. For-profit
Analyst
hospitals will also benefit from an estimated 8.44% rate increase for non-drug service james.kurek@ubs.com
payments under the OPPS (though not for ASCs), which is necessary to maintain budget +1-212-713 3704
neutrality as CMS is proposing to make cuts to 340B drug reimbursement for non-profit
Jonathan Yong
hospitals (more details below) The positive 2.4% base rate update and positive
8.44% budget neutrality-related update under the OPPS are partially offset by a 3% jonathan.yong@ubs.com
reduction as CMS proposes to accelerate the recoupment of past overpayments. While +1-212-713 6268
not directly additive, these factors roughly combine to a 7.5% to 8.0% rate increase for
Michael Wei
outpatient hospital services, significantly above the typical base rate increase of 2-3%.
For reference, outpatient Medicare FFS payments account for around ~6% of HCA's michael.wei@ubs.com
total net patient revenues. The ~500 bps of rate increase above the norm equates to ~ +1-212-713 2565
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