Each year millions of patients visit their doctors’ offices for a variety of routine services. But in recent years more Americans are being charged as if they had visited a hospital. This is because the doctor’s office billing them is pretending to be a hospital. When a hospital bills a patient’s insurer, it must report […]
Did you know that the exact same procedure can be more expensive depending on where you have it done? Most people know that if they receive care in their doctor’s office or go to a lab or imaging center, rather than the hospital, they won’t be charged as much. But when a doctor’s office or […]
Congress is currently considering policies that would expand site-neutral payment for ambulatory services in the Medicare program. These policies would reduce hospital revenues, while generating savings for Medicare beneficiaries and the federal government and removing an incentive to shift services out of physician offices and into hospitals. Some policymakers have suggested using a portion of […]
Inside Health Policy, May 17, 2023 House Energy & Commerce Chair Cathy McMorris Rodgers (R-WA) ultimately pulled a Medicare site-neutral pay expansion amendment from consideration during the health subcommittee’s Wednesday (May 17) markup of wide-ranging health legislation, saying the committee had more work to do on the policies — but she implored hospitals to work […]
When Brittany Tesso’s then-3-year-old son, Roman, needed an evaluation for speech therapy in 2021, his pediatrician referred him to Children’s Hospital Colorado in Aurora. With in-person visits on hold due to the covid-19 pandemic, the Tessos met with a panel of specialists via video chat. The specialists, some of whom appeared to be calling from […]
Kyunghee Lee’s right hand hurts all the time. She spent decades running a family dry cleaning store outside Cleveland after emigrating from South Korea 40 years ago. She still freelances as a seamstress, although work has slowed amid the covid-19 pandemic. While Lee likes to treat her arthritis with home remedies, each year the pain […]
The Trump administration will have a tough time defending its effort to ensure that Medicare pays the same rates for services provided at hospital outpatient clinics as at doctors’ offices. The American Hospital Association and dozens of hospitals around the country are challenging the Centers for Medicare & Medicaid’s decision to lower payments to off-campus […]
Where people receive health care matters, especially in terms of costs. The same services may have a much higher price tag when performed in one setting rather than another, but this price difference is rarely publicized to patients. To understand what settings people used and how prices differed, we looked at the utilization and average […]
Democrats are engaged in indiscriminate attacks on President Trump’s 2020 budget proposal. They are ignoring some worthy ideas. Senate Democrats, including several of the party’s presidential candidates, have savaged President Trump for proposing to reduce Medicare spending by several hundred billion dollars over the next decade. Senator Kamala Harris of California said the proposed changes […]
As Congress debates partisan issues such as “Medicare for All” where private health insurance would be outlawed, troubling trends are emerging on healthcare provider consolidation that are driving up costs. ACOs’ Underwhelming Performance There is a long-standing belief — particularly in liberal and academic health-policy circles — that physician–hospital integration into larger systems would improve […]