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At the December 4, 2025, Medicare Payment Advisory Commission (MedPAC) annual session on payment adequacy for Medicare providers, draft fiscal year (FY) 2027 payment recommendations were issued. The recommendations, “Assessing Payment Adequacy and Updating Payments: Inpatient Rehabilitation Facility (IRF) Services,” were shared. Included in their presentation were their findings on admissions, financial performance by IRF provider type, quality metrics, and other relevant data points. In addition to the payment-focused sessions, the meeting included a general session on post-acute care trends and “key issues,” which compared various patient- and payment-focused data across IRFs, skilled nursing facilities (SNF), and home health agencies (HHA).

During the IRF payment session, MedPAC advanced a draft recommendation calling for Congress to reduce the 2026 Medicare base payment rate for IRFs by 7 percent in FY 2027. This draft recommendation is identical to last year’s recommendation and marks an increase over the FY 2025 recommendation (a 5% cut to the Medicare base payment rate) and the FY 2024 finalized recommendation (3% cut).

MedPAC’s recommendations are advisory in nature, and most of MedPAC’s work can only be implemented via Congressional action. RCPA will monitor the status of these recommendations through close collaboration with the American Medical Rehabilitation Providers Association (AMRPA).

The Medicare Payment Advisory Committee (MedPAC) voted last week and unanimously recommended a five percent payment reduction for inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies (HHAs). There was no additional feedback provided with this recommendation; however, additional information should be provided in their upcoming March 2022 report to Congress.

Also worth noting was that MedPAC discussed its mandated report related to designing a value incentive program (VIP) for post-acute care (PAC). This report is required under the Consolidated Appropriations Act of 2021, and this was the commission’s second session dedicated to development of the PAC VIP. The report is due to Congress by March 15, 2022. Due to the limited time to develop the report, MedPAC asserted it would not be making a formal recommendation in the March Report to Congress. Also during this session, MedPAC shared its plan to submit its separate report on a unified post-acute care payment prototype to Congress in 2023.