National Daily Hospital Executive Briefing — Monday November 10, 2025
In this issue: Physician Fee Schedule, CMS Hospital Penalty List, ED Boarding Correlates to Staff Burnout and Turnover
Early Morning Briefing Headlines
CMS finalized the CY 2026 Physician Fee Schedule (PFS) with conversion factors rising ~3.3–3.8% over CY 2025; outpatient/ASC 2026 final rule is still pending.
ED boarding remains a national safety and workforce issue; new federal summit report synthesizes evidence and strategies to reduce boarding. Staff burnout and turnover directly related to boarding hours.
CMS continues active enforcement of Hospital Price Transparency; leaders should verify full compliance and machine‑readable file integrity.
Global & Health Sector Headlines
News — CMS issues CY 2026 PFS Final Rule; policy updates effective Jan 1, 2026. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f
News — Federal Register posts the CY 2026 PFS final rule details for official reference. https://www.federalregister.gov/documents/2025/11/05/2025-19787/medicare-and-medicaid-programs-cy-2026-payment-policies-under-the-physician-fee-schedule-and-other
Recommendation — AAMC summary flags 2026 conversion factors ($33.57 for QPs; $33.40 for non‑QPs) and QPP updates — use it for quick clinician comms. https://www.aamc.org/advocacy-policy/washington-highlights/cms-releases-2026-medicare-physician-fee-schedule-quality-payment-program-rule
Recommendation — Policy brief for finance/govt‑relations: McDermott+ summary translates technical changes into operational impacts. https://www.mcdermottplus.com/insights/cms-releases-cy-2026-physician-fee-schedule-final-rule/
Emergency Department Boarding
News — AHRQ’s ED Boarding Summit report calls the crisis a patient safety and public health emergency with actionable domains for hospitals. https://www.ahrq.gov/sites/default/files/wysiwyg/topics/ed-boarding-summit-report.pdf
News — National reporting highlights scale: one in six ED visits with admission had >4‑hour waits (2022), with over half of boarded patients age 65+; systemic capacity constraints persist. https://apnews.com/article/daf48acf11631cffdaeb5de4abe3722e
Case Study — Connecticut system‑wide analysis shows 38.7% of admitted patients waited >4 hours for beds, with some sites >60%, spurring state‑level responses. https://www.ctinsider.com/business/article/ct-emergency-room-boarding-hospitals-20363439.php
Recommendation — Peer‑reviewed synthesis links boarding to staff burnout and turnover; prioritize throughput fixes with workforce protections. https://pmc.ncbi.nlm.nih.gov/articles/PMC12342924/
Hospital Finance (Price Transparency)
News — CMS maintains public list of civil monetary penalties for non‑compliance; verify your organization is not listed and documentation is complete. https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/enforcement-actions
Recommendation — Use CMS price transparency enforcement dataset to self‑audit machine‑readable file and shoppable services display. https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-price-transparency-enforcement-activities-and-outcomes
Recommendation — Review CMS overview to ensure required elements are posted correctly (machine‑readable + shoppable services). https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency
Strategic Implications for Leadership
Model CY 2026 revenue impacts by service line using final PFS CFs and update clinician compensation/QPP messaging accordingly (clinic + employed specialists).
Escalate ED‑to‑inpatient flow redesign as an enterprise priority (capacity commands, discharge-before-noon, weekend staffing, and hospital‑at‑home pathways).
Work with HR to develop and implement turnover and burnout ratings internally, as a new dashboard, then a task force to address clinically - sensitive areas, and monitor progress, incl ED holding.
Run a 48‑hour price‑transparency compliance sprint: validate MRF schema, payer‑negotiated rates completeness, and shoppable list usability; brief board quality/finance.
Coordinate with state hospital association on external policy timing (e.g., OPPS/ASC final when released) to adjust capital and service‑mix planning.
Quality Metrics to Share with Your Team (≤7)
CY 2026 PFS conversion factors: $33.5675 (QPs) and $33.4009 (non‑QPs) — up ~3.77% and 3.26% vs CY 2025. Source: https://www.aamc.org/advocacy-policy/washington-highlights/cms-releases-2026-medicare-physician-fee-schedule-quality-payment-program-rule
AHRQ: ED boarding identified as national safety crisis; hospitals report waits of hours to days for medical/surgical placements. Source: https://www.ahrq.gov/sites/default/files/wysiwyg/topics/ed-boarding-summit-report.pdf
AP: ~1 in 6 ED admissions in 2022 had >4‑hour waits; >50% of boarded patients age 65+. Source: https://apnews.com/article/daf48acf11631cffdaeb5de4abe3722e
Connecticut statewide snapshot: 38.7% of admitted patients waited >4 hours for inpatient beds; some hospitals >60%. Source: https://www.ctinsider.com/business/article/ct-emergency-room-boarding-hospitals-20363439.php
CMS price‑transparency enforcement: active CMP notices published; dataset available for cross‑checking. Source: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency/enforcement-actions
Self‑audit resource: CMS enforcement dataset for compliance tracking. Source: https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-price-transparency-enforcement-activities-and-outcomes
Leadership Call to Action (≤5)
Publish an internal PFS 2026 impact brief this week with service‑line revenue deltas and physician comp/QPP updates; align budgets before December close.
Launch an ED flow 'Code Capacity' playbook: daily bed meetings, discharge-before-noon targets, weekend rounding, and prioritized step‑down/HAH placements.
Stand up a price‑transparency tiger team (IT + RevCycle + Legal) to validate MRFs and shoppable pages; correct gaps and document governance in 7 days.
Prepare OPPS/ASC watchlist and decision memos so you can implement the final rule within 30 days of release.
Report monthly to the board on ED boarding hours, left‑without‑being‑seen, and inpatient discharge timeliness, with corrective actions and owners.
📍 Published at National Daily Hospital News
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