A recent study from the American Cancer Society Cancer Action Network and Avalere reviewed Medicare costs for services a hypothetical breast cancer patient receives in a calendar year. The study found:
- Services provided in HOPDs were reimbursed at a rate that was 3 times higher than services provided in a physician office setting;
- Certain services provided in HOPDs were reimbursed at rates that were more than 5-6 times higher;
- The hypothetical patient would have experienced a $1,500 reduction in out-of-pocket (OOP) costs over the course of a year if site neutral payment had been implemented;
- Medicare Part B spending would have been $7,750 less if site neutral payment was in place; and
- Targeted site neutral payment reforms could lower both patient OOP costs and overall Medicare Part B spending.
To read the full study, click here.