CMS 2027 Outpatient Pay Proposal: 2.4% Increase, 340B Cuts and Site-Neutral Expansion
CMS is proposing a 2.4% increase in outpatient and ambulatory surgical center payments for 2027, alongside a cut to the 340B drug discount and a broader push toward site-neutral payment. The proposed OPPS rule raises rates 3.2% for cost inflation, offset by a 0.8% productivity adjustment, and adds $55 million for hospitals in Alaska and Hawaii. CMS would reduce the 340B discount to 33.4% of average sales price, down from roughly 40%, citing wide disparities in hospital acquisition costs. The agency also proposes lower hospital reimbursement for some imaging services under site-neutral policy and is seeking comment on stronger price transparency requirements. Hospital groups, including America’s Essential Hospitals, have criticized the proposal as a blow to safety-net funding.
Payment rules set the revenue baseline for every outpatient and ASC operator. A 2.4% update trailing real cost growth, 340B compression, and expanding site-neutral policy all tighten hospital outpatient economics — and shift relative advantage toward freestanding ASCs and physician-owned sites that many growth-stage platforms operate.
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How much is CMS proposing to increase outpatient and ASC payments for 2027?
CMS proposes a 2.4% payment increase for both hospital outpatient departments and ambulatory surgical centers in calendar year 2027. The update reflects a 3.2% increase for higher costs of goods and services, offset by a 0.8% productivity adjustment, plus roughly $55 million in added payments for hospitals in Alaska and Hawaii.
What happens to the 340B drug discount under the proposed 2027 OPPS rule?
CMS proposes reducing the 340B discount to 33.4% of a drug’s average sales price, down from the current discount of about 40%. The agency cites a hospital survey showing significant disparities between hospital acquisition costs and current discount levels.
Does the 2027 OPPS proposal expand site-neutral payment?
Yes. CMS proposes reducing hospital reimbursement for certain imaging services and continues pushing to pay hospitals and clinics at similar rates for some outpatient services. Hospital groups have opposed the change, while CMS frames it as giving patients lower-cost options for care.