Alliance asks lawmakers to level the playing field to ensure the exact same care is reimbursed at the same payment level despite the delivery setting
WASHINGTON – The Alliance for Site Neutral Payment Reform – a coalition of patient advocates, providers, payers and employers, who support payment parity across site of service – today sent letters to House and Senate leadership, as well as the leadership of the House Ways & Means, Energy & Commerce, and Senate Finance Committees urging Congress to consider the significant cost savings associated with site neutral payment reform. The Alliance is asking lawmakers to work with them in the year ahead to expand policies to equalize payments across sites of service for all outpatient services to improve health care for all Americans and protect access to quality, cost effective community-based care.
While the 114th Congress advanced site neutral payment policy, the Alliance encourages lawmakers to pass additional reforms. The Bipartisan Budget Act of 2015 (BBA) established a site neutral payment policy for all newly acquired provider based off-campus hospital outpatient departments (HOPD), which the Alliance advocated strongly for and commended as a positive first step toward leveling the playing field to ensure the exact same care is reimbursed at the same payment level despite the delivery setting. However, provisions in the 21st Century Cures legislation exempt cancer hospitals and certain HOPDs from the site neutral payment policy.
Instead of restricting site neutral reforms, the Alliance hopes to work with the new 115th Congress to adopt payment parity policies to decrease unnecessary Medicare and commercial spending, ensure patients receive the right care in the right setting, lower taxpayer and beneficiary costs, and increase patient access.
Excerpts from the Alliance letter include:
“As the new 115th Congress sets out to reform our nation’s health care delivery system in the year ahead, the Alliance urges you to consider the significant savings associated with site neutral payment reforms – savings that directly and positively impact senior beneficiaries, the Medicare program, employers and American taxpayers.”
“The need for site neutral payment reforms is evident – payment policies supporting higher reimbursement in the hospital outpatient department (HOPD) setting have resulted in increased costs to patients, employers and taxpayers. Across the Medicare program, reimbursement rates vary significantly based solely on site of service and not the healthcare service provided.”
“In addition to higher costs to the healthcare system, payment policies that support higher reimbursement in the HOPD setting encourage the acquisition of office-based physician practices, further restricting patient access to care in the lower cost community setting. The Alliance warns that unless steps are taken to stem consolidation in the health care marketplace through the advancement of site neutral payment policies, healthcare spending will continue to increase while patient access to community-based care will decrease.”
“We strongly encourage you and your colleagues in Congress to embrace commonsense changes to our healthcare delivery system that will lower costs for patients, provide savings and stability for the Medicare program and promote competition in the healthcare marketplace. To do so, we urge Congress to expand the application of site neutral payment policies to all off-campus outpatient services.”
The Alliance for Site Neutral Payment Reform is a coalition of patient advocates, providers and payers who support payment parity across site of service to decrease Medicare and commercial spending, ensure patients receive the right care in the right setting, lower taxpayer and beneficiary costs and increase patient access. To learn more, visit siteneutral.org.