Insights: Healthcare

Medicare Inpatient Rehabilitation Facility (IRF) Reimbursement

As part of the FY26 IRF proposed rule, CMS is proposing to increase IRF payments by 2.6% ($295m) relative to FY25.

Medicare Hospice Reimbursement

As part of the FY26 hospice proposed rule, CMS is proposing to increase hospice payments by 2.4% ($695m) relative to FY25 levels and set the annual per beneficiary payment cap at $35,292.51 (increased from $34,465.34 in FY25).

Medicare Skilled Nursing Facility (SNF) Reimbursement

As part of the FY26 SNF proposed rule, CMS is proposing to increase SNF payments by 2.8% ($1b) relative to FY25.

Medicare Inpatient Hospital (IPPS) Reimbursement

As part of the FY26 IPPS proposed rule, CMS is proposing to increase inpatient hospital payments by 2.4% ($4b) relative to FY25.

Medicaid Reimbursement

CMS has informed states it will not approve new or extend existing requests for federal dollars on designated state health programs (DSHPs) and designated state investment programs (DSIPs). DSHPs and DSIPs represent ~$2.7b in Medicaid spending in CY25.

Recent/upcoming developments… In recent weeks, HHS Secretary Kennedy has made a variety of statements pressuring states to consider banning the purchase of “soda” with SNAP benefits. Republican-led states appear to be heeding those calls, with WV Governor Morrisey indicating his state would seek USDA approval of such a ban and the ID legislature...