A new research brief from the Actuarial Research Corporation and supported by Arnold Ventures provides a deep dive into the potential cost impacts of site neutral payments for off-campus drug administration services in Medicare.
Per Arnold Ventures, the analysis estimates “if site neutral payments for drug administration in off-campus facilities had been in place in 2021:
- “Total fee-for-service Medicare costs would have been $161 million lower.
- Beneficiary cost sharing would have been $40 million lower.
- Medicare patients receiving level 4 drug administration would have paid $40 less per service, keeping in mind many patients receive multiple drug administration services over a course of treatment.
- Chemotherapy patients would have paid $292 less in cost sharing. And the highest-need chemotherapy patients would have paid more than $1,000 less.”
“The brief also found:
- “68% of drug administration services are performed in a physician’s office, meaning it is safely provided in a doctor’s office a majority of the time.
- Medicare pays 200 – 300% more when drug administration services are provided in an off-campus hospital outpatient department rather than in a physician office.”
Read more from Arnold Ventures here.
Read the full ARC research brief here.