Medicare at 60: A New Chapter for Hospitals — and a Fresh Opportunity for Wound Care Programs

A Milestone Worth Celebrating

On July 30, 1965, Medicare and Medicaid became promises to the American people — to protect dignity, expand access, and ensure no one would go without care because of age or income.

Sixty years later, these two programs support more than 140 million Americans and remain foundational pillars for hospitals, safety-net providers, and wound care teams across the country.

At Shared Health Services, we’re proud to honor that legacy — and even prouder to support the hospitals and clinicians who live it every day.

A Legacy of Access and Equity

Medicare and Medicaid have evolved from groundbreaking concepts into two of the largest and most trusted health care programs in the world.

• Medicare now serves over 65 million Americans, including individuals 65 and older, and those with disabilities.

• Medicaid covers more than 85 million people, providing a safety net for low-income families, children, pregnant women, and seniors who require long-term care.

These programs have enabled Shared Health Services to partner with hospitals and physician practices to help them deliver wound care and hyperbaric oxygen therapy services to some of the nation’s most medically complex patients—often when they need care most.

Medicare vs. Medicaid: What’s the Difference?

Though often mentioned together, Medicare and Medicaid serve different roles in the U.S. health care system:

Medicare is a federal program providing health insurance to individuals 65 and older, as well as certain younger individuals with disabilities or end-stage renal disease. Coverage is consistent across all states and includes:

• Part A – Hospital insurance

• Part B – Medical services

• Part C – Medicare Advantage (private plan alternatives)

• Part D – Prescription drug coverage

Medicaid is a joint federal and state program that supports low-income individuals and families, with benefits and eligibility varying by state. Medicaid also provides long-term care services and home-based supports not typically covered by Medicare.

Some patients qualify for both programs, known as dual eligibility, enabling them to access more comprehensive care.

60 Years of Impact

Over the past six decades, Medicare and Medicaid have:

• Expanded health care access to rural and underserved communities

• Protected seniors from catastrophic medical costs

• Advanced preventive care and chronic disease management

• Enabled care innovation through bundled payments, value-based models, and care coordination efforts

• Supported community-based care for patients who require long-term support outside of institutional settings

At Shared Health Services, we have witnessed firsthand how these programs have changed lives—bringing healing, hope, and stability to countless patients who may otherwise have gone without essential care.

Medicare at 60 — and Still Evolving

On July 31, 2025, the Centers for Medicare & Medicaid Services (CMS) finalized its fiscal year 2026 Inpatient Prospective Payment System (IPPS) rule¹. The update brings a mix of financial support and operational change — all of which matter to hospital-based wound care programs navigating today’s fast-moving landscape.

Here are five updates worth your time:

1. Medicare Payment Rates Are Going Up

CMS finalized a 2.6% inpatient hospital pay bump for 2026 — slightly higher than proposed. This increase is expected to add $5 billion in hospital funding, including $2 billion in uncompensated care payments for facilities serving low-income patients². It’s a meaningful gesture toward hospitals bearing the brunt of today’s coverage gaps.

2. Long-Term Care Hospitals Receive 2.7% Increase

Long-term care hospitals (LTCHs) will see a 2.7% increase in Medicare payments, helping sustain care for high-acuity patients and easing pressure on acute care partners².

3. CMS Ends Low Wage Index Policy — Adds Transition Support

After a federal court ruling, CMS is discontinuing its low wage index policy³. To ease the impact, a narrow, budget-neutral transitional exception will support hospitals affected by the change — especially helpful for rural providers.

4. Hospital Quality Measures Are Evolving

CMS is revising its Inpatient Quality Reporting Program by:

• Updating complication and mortality measures (e.g., stroke and hip/knee arthroplasty)⁴

• Requiring hybrid readmission data for 70% of discharges⁵

• Removing four equity and social risk screening measures⁶

Wound care teams may see increased emphasis on outcomes and documentation consistency — especially when caring for complex patients.

5. Interoperability Requirements Are Getting Stronger

CMS is pushing hospitals toward better information exchange and EHR security:

• A 180-day EHR reporting period is now required²

• Hospitals must complete annual risk assessments and self-audits²

• New bonus measures reward public health data sharing through trusted exchange frameworks²

A Win Worth Noting: Hospitals Are Being Heard

While the AHA still voices concern about financial adequacy, they praised CMS for “supporting hospitals that treat a disproportionately high number of low-income patients” in the final rule⁷.

For hospitals running wound care and hyperbaric oxygen therapy programs, this update is a rare chance to reinforce staffing, improve workflows, and plan ahead with confidence.

How SHS Supports Partners Through Policy Change

For 25+ years, Shared Health Services has worked shoulder-to-shoulder with hospitals and physician practices to extend the reach of Medicare and Medicaid — helping teams deliver wound care and hyperbaric oxygen therapy to patients who need it most.

At SHS, we don’t run your wound care program — we equip your team to succeed in it. That includes helping you respond to change with clarity, confidence, and practical tools.

Here’s how we help our partners navigate Medicare’s evolution:

• Compliance-ready documentation systems - Built around CMS expectations, payer logic, and defensible billing and coding practices.

• Peer-to-peer training and clinical support - From CHTs/CHSs to program directors, our team helps yours stay current, confident, and capable.

• Discharge planning resources - Designed to flag social risks, support continuity, and minimize bounce-backs.

• Reimbursement guidance - Aligned with site-specific billing strategy, revenue retention, and MAC documentation rules.

“Our role is to support your team with proven strategies and clinical expertise —

the success is yours to own.”

Medicare at 60: Still Worth Believing In

Sixty years ago, Medicare and Medicaid were bold new ideas. Today, they are lifelines — woven into the fabric of American health care.

This anniversary isn’t just about policy. It’s about people. And for 60 years, Medicare and Medicaid have helped hospitals and physicians show up for those who need them most.

At Shared Health Services, we are proud to stand alongside the hospitals, clinicians, and patients these programs were built to support. We celebrate their legacy — and we’re ready for what’s next — one patient, one program, one community at a time.

📞 Ready to strengthen your wound care program?

Email us at - sales@sharedhealthservices.com

Or call us at - (800) 474-0202

Let’s talk strategy.

References:

1. Condon A. CMS finalizes 2.6% pay bump for hospitals in 2026: 8 things to know. Becker’s Hospital Review | Healthcare News & Analysis. Published July 31, 2025. https://www.beckershospitalreview.com/finance/cms-finalizes-2-6-pay-bump-for-hospitals-in-2026-8-things-to-know/

   
   

2. FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F | CMS. Cms.gov. Published July 30, 2025. Accessed August 1, 2025. https://www.cms.gov/newsroom/fact-sheets/fy-2026-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective-0

   
   

3. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes. Federal Register. Published April 30, 2025. Accessed August 1, 2025. https://www.federalregister.gov/documents/2025/04/30/2025-06271/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the

   
   

4. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes. Federal Register. Published April 30, 2025. Accessed August 1, 2025. https://www.federalregister.gov/documents/2025/04/30/2025-06271/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the

   
   

5. Heilman E. 2026 IPPS Proposed Rule | Medisolv. Medisolv.com. Published April 18, 2025. Accessed August 1, 2025. https://blog.medisolv.com/articles/2026-ipps-proposed-rule

   
   

6. kcastady@parthenonmgmt.com. The Undoing of SDoH Reporting: What Case Managers Need to Know About CMS’s FY 2026 Proposed Rollbacks  | CMSA. Cmsa.org. Published 2025. https://cmsa.org/the-undoing-of-sdoh-reporting-what-case-managers-need-to-know-about-cmss-fy-2026-proposed-rollbacks/

   
   

7. bmirza_drupal. CMS issues hospital IPPS final rule for FY 2026 | AHA News. American Hospital Association | AHA News. Published 2025. Accessed August 1, 2025. https://www.aha.org/news/headline/2025-07-31-cms-issues-hospital-ipps-final-rule-fy-2026