Consumers First Submits Comments On OPPS 2026

Families USA, on behalf of Consumers First and joined by 16 organizations provided comments on the Medicare Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2026 proposed rule. Consumers First is a collective of members working together to hold the nation's health care system accountable to providing everyone with affordable, high-quality, cost-effective care. One essential lever to achieving this goal is the enactment of improved Medicare payment policy, which in turn establishes a standard that is often adopted by commercial payers and Medicaid.

The proposed changes outlined in the rule could catalyze the transformational change that is needed to ensure our payment systems drive high value care across the country. While expansion of some policies is encouraged, Consumers First opposes the proposed removal of quality measures that focus on health equity and social drivers of health (SDOH). It is strongly recommended that CMS retain these measures and the ability to collect data on the non-medical drivers of health in order to hold hospitals accountable for health outcomes.