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 […]
Extending and establishing site-neutral payments for outpatient services is the key to lowering healthcare costs, a coalition of patient advocates, providers, payers, and employers recently told top policymakers. “Site neutral payment reforms have long had bipartisan support from policymakers, healthcare economists, regulators and MedPAC,” the Alliance for Site Neutral Payment Reform wrote in a Feb. 20 letter. […]
Data show that the majority of Americans experience stress tied to medical costs for treating illnesses or purchasing medications. Premiums for most health insurance plans continue to increase as more patients find themselves paying more out-of-pocket in the form of higher co-pays and deductibles. Cancer patients face particular hardship. A recent survey found that 70 […]
By Deepak Kapoor | October 25, 2018 Recent efforts by the nation’s hospital industry illustrate the difficulty of controlling expenditures in the nation’s $700 billion Medicare program. Congress included in the Bipartisan Budget Act of 2015 (BBA), a clear, bipartisan message that, to the extent similar services can be safely provided in multiple settings, […]
By Laura Dyrda | August 14, 2018 The American Association of Orthopaedic Surgeons supports CMS’ Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System’s proposed rule to move the two sites of service closer to site-neutral payments. The new rule would reduce the payment rate for hospital outpatient clinic visits provided at off-campus […]
By Ted Okon | August 6, 2018 As we enter the election season American outrage and concern over health care costs continues to be a priority issue on voters’ minds. The byzantine and complex system we have built continues to present a formidable burden for policymakers who must face the entrenched but completely […]
By Kerry Dooley Young | August 2, 2018 Medicare officials may get significant support from some physicians and insurers for their bid to end higher payments for identical and similar medical services provided in hospital-owned clinics than in independent practices. The Centers for Medicare and Medicaid Services (CMS) said it intends to use […]