WASHINGTON, DC—The American College of Emergency Physicians (ACEP) applauds the Centers for Medicare & Medicaid Services (CMS) for finalizing the new Emergency Care Access and Timeliness measure in the Calendar Year 2026 Medicare Hospital Outpatient Prospective Payment System (OPPS) final rule. This measure represents a critical step toward confronting one of the most dangerous and pervasive problems in health care today: hospital patients boarding in emergency departments (EDs).

Boarding occurs when emergency patients who have been admitted to the hospital are forced to wait—often for many hours or even days—in the emergency department until an inpatient bed becomes available. This crisis affects every kind of patient, and it reverberates throughout entire communities as crowded emergency departments struggle to remain ready for the next emergency.

By requiring hospitals to more accurately track and publicly report how long admitted patients are boarded in the ED, CMS is shining a needed spotlight on a problem that has for too long been invisible in national quality reporting.

“Every day across the country, emergency physicians are caring for admitted patients in hallways, storage areas, and any space that can safely hold a stretcher because there simply are not enough inpatient beds,” said ACEP President L. Anthony Cirillo, MD, FACEP. “You cannot fix what you refuse to measure. This new Emergency Care Access and Timeliness measure is an essential first step toward real accountability for ED boarding and toward getting patients out of hallways and into beds so that they can get the care they need with the dignity they deserve.”

ACEP also appreciates that CMS has included flexibility for rural emergency hospitals, acknowledging the unique challenges of maintaining access to emergency care in rural communities while still recognizing the importance of monitoring boarding in those settings.

The boarding crisis will not be solved overnight, but the adoption of this measure is a foundational policy change that will help drive system-level solutions. ACEP looks forward to working with CMS, hospitals, policymakers, and other stakeholders to build on this momentum and ensure that every patient has timely access to safe, high-quality emergency care when they need it most.