Patients like Gay Miller, a North Carolina resident who paid almost $900 more than her typical $60 co-pay for a routine 30-minute echocardiogram, are feeling the angst of increased out-of-pocket (OOP) costs solely attributable to a change in site of care. Gay received her echocardiogram at a hospital outpatient department (HOPD) as opposed to her […]
Joel M. Zinberg April 26, 2016 | InsideSources As policymakers struggle to rein in healthcare costs, it would seem obvious that medical services should be performed in the most efficient, lowest cost, clinically appropriate setting. But Medicare payment systems are moving outpatient care into the most expensive venues, wasting scarce insurance and patient dollars – […]
Community oncologists want Congress to stay the course on Medicare site-neutral pay policy, although they are open to exempting facilities under development, if they don’t include oncology practices, from lower pay rates in narrow circumstances. The Community Oncology Alliance fears that if Congress rolls back site-neutral restrictions or retroactively delays the policy’s start date, hospitals […]
There is likely no clear winner in the fight between hospital and physician groups who are weighing in on Medicare’s new site-neutral payment policy that goes into effect next year. Hospitals with newly acquired and almost-built physician practices located off of the main campus are hoping a congressional committee will put the brakes on payment […]
Although Congress took an initial step toward equal payments for physicians’ services regardless of where they practice when it passed the Bipartisan Budget Act last November, many office-based physicians still receive lower payments for the same services than do their colleagues in hospital outpatient settings. Read full article >>
House Republicans are considering using the omnibus appropriations bill to make changes to the Medicare site-neutral pay policy included in the budget deal that Congress passed in late October, Ways & Means Chair Kevin Brady (R-TX) said. Brady didn’t say what changes are being considered, but the American Hospital Association is lobbying Congress to exempt […]
Washington—There was generally positive news for Medicare providers in the new 2-year budget agreement signed into law by President Obama Nov. 2 as well as the 2016 physician fee schedule just released by the Centers for Medicare & Medicaid Services (CMS). But hospital-owned physician practices will take a hit under the budget deal, and urologists […]
The Alliance for Site Neutral Payment Reform is lobbying to expand a new site-neutral pay law to hospital acquisitions of doctor practices, and group members say site-neutral pay is key to getting the new physician pay scheme right. As the alliance seeks to expand the site-neutral pay law, hospitals are trying to exempt outpatient facilities […]
The budget and debt-limit deal reached Monday night would cut Medicare spending by instituting a new policy under which CMS would no longer pay higher hospital-outpatient rates when hospitals buy physician practices and ambulatory surgical centers. Hospitals oppose the measure, but primary physicians and independent cancer centers support it. A previous story on Inside Health […]
Improving Medicare quality and efficiency, in order to keep the program solvent for the nearly 10,000 new beneficiaries who turn 65 years old each day,1 has been an ongoing priority for Congress and policy makers. Efforts to improve patient safety and outcomes, while tying payments to quality instead of quantity, have resulted in a seismic […]