The White House says finalized Medicare outpatient rules will cut senior costs by more than $1 billion next year, while hospital groups warn the same changes squeeze safety-net hospitals.
The White House message
On Thursday afternoon, the official @WhiteHouse account posted that “New Medicare policies will lower costs by more than $1 BILLION for seniors next year,” calling the changes “effective policy to help the American people where they need it most.”
The post pointed to rules the Centers for Medicare & Medicaid Services finalized Wednesday for calendar year 2027 hospital outpatient and ambulatory surgical center payments. CMS itself posted that the rule expands outpatient surgery options, lowers out-of-pocket costs for imaging and 340B drugs, and updates 2027 payment rates.
What the rule changes
According to CMS estimates summarized in free coverage of the final rule:
- Payment for separately payable drugs bought under the 340B discount program will move to average sales price minus 28% in 2027 (CMS had proposed a deeper cut).
- Original Medicare beneficiaries are projected to save about $1.1 billion on those drug costs in 2027.
- Patients who get a qualifying drug in a hospital outpatient department are expected to save about $900 on average that year.
- Extending site-neutral rates to more imaging without contrast at off-campus hospital clinics is estimated to save beneficiaries and taxpayers about $260 million in 2027 and more than $9 billion from 2027 through 2036.
Overall outpatient payment rates still rise a net 2.3% in 2027 for hospitals that meet quality reporting rules, the American Hospital Association reported.
Hospital pushback
Hospital groups say the math lands differently on the ground. AHA senior vice president Ashley Thompson said CMS’s outpatient rates do not fully reflect financial pressure on hospitals, “amplified for hospitals serving rural and underserved communities.”
Thompson also criticized the site-neutral imaging cut, arguing hospital outpatient departments treat sicker, more complex patients than independent clinics. On 340B, she said reduced reimbursement and a faster clawback of earlier payments will “further stress hospitals’ ability to care for their patients.”
Rural sole community hospitals and some specialty hospitals are exempt from parts of the 340B and imaging changes, according to AHA’s summary of the rule.
What this means for you
- If you have Original Medicare and get infused or injected drugs at a 340B hospital outpatient clinic, CMS says your coinsurance should fall in 2027.
- Imaging: Some X-rays, ultrasounds, CT scans, MRIs, and bone-density scans at off-campus hospital sites are set to use lower physician-office-style rates.
- Timing: The payment changes take effect Jan. 1, 2027, not immediately.
White House spokeswoman Allison Schuster told the Daily Signal the policies end “intentional Medicare overpayments” for outpatient drugs and build on other administration cost efforts. Hospitals say those savings come out of programs that fund care for low-income patients.
Sources: White House on X, CMSGov on X, AHA News, Medical Daily, United States Tribune CMS summary, Daily Signal
