There is considerable data showing that disparities in payment across sites of service increase costs to patients, insurers and taxpayers as well as result in marketplace consolidation that limits patient choice by reducing access to care in the community-setting.

February 9, 2024

Analysis Examines Impact of Site Neutral Proposals in Rural Areas

A recent analysis from the Actual Research Corporation examines various options for expanding site neutral payments at off-campus hospital outpatient departments (HOPDs).  Findings include: “• Only 19% of Medicare off-campus HOPD spending is subject to existing outpatient payment system site neutrality policies. • Medicare and beneficiaries typically pay 2-4X more for a service in an […]

December 6, 2023

New Research Dives into Site Neutral Cost Savings in the Lower Cost, More Transparency Act

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 […]

November 10, 2023

New Whitepaper Examines Impact of Site Neutral Payment Reforms Across Multiple Disease Groupings

A new study conducted by Wakely Consulting Group and sponsored by the Leukemia & Lymphoma Society examines the impact of site neutral payment across outpatient settings, finding that these reforms have the potential to “significantly reduce out-of-pocket patient spend.” The analysis focuses on eight disease groups: breast cancer, colitis, chronic obstructive pulmonary disease (COPD), Crohn’s […]

October 24, 2023

ACS-CAN Study Shows Benefits of Site Neutral Payments in Cancer Care

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 […]

September 14, 2023

BCBSA: Costs for Common Health Care Procedures Significantly Higher When Performed in Hospital Outpatient Departments

An analysis released by the Blue Cross Blue Shield Association (BCBSA) shows the costs for prevalent procedures like mammograms or colonoscopies were consistently higher — as much as 58% more expensive — when performed in HOPD settings. Higher hospital prices mean higher costs to consumers.  The analysis looked at claims data for six common, everyday […]

June 26, 2023

Paragon Policy Brief on Site Neutral Payment Refrorms

A recent policy brief from Paragon Health Institute finds “enacting ‘site neutral’ policies across health care settings can save taxpayers and patients money without sacrificing quality and can fight provider consolidation.” The brief  is intended to provide an overview Medicare site of service differentials, their implications, recent policy actions to address them, and potential options […]

April 26, 2023

New Survey Finds Strong Support for Site Neutral Payment Reform

A recent survey of registered voters conducted by a bipartisan polling team and supported by Arnold Ventures found the following: 85% of voters support limiting outpatient fees to the same price charged by doctors in the community 75% of voters support preventing hospitals from engaging in business tactics that reduce competition 80% of voters say hospital […]

March 16, 2023

Brookings: Enact Site Neutral Payments to Increase Competition

A recent report from the Brookings Institution highlights several policies that could reduce health care costs by increasing competition. The authors argue these policies have attracted various levels of bipartisan interest in recent years and could make progress in a divided Congress. According to the report, “In addition to the direct costs, paying more for […]

March 10, 2023

BCBSA: Site-Neutral Payments Would Save Nearly $500 Billion Over 10 Years

The Blue Cross Blue Shield Association (BCBSA), a member of the Alliance for Site Neutral Payment Reform, recently released a white paper titled, “Delivering Lower Costs for Patients and Taxpayers Through Site-Neutral Payment Reform,” which makes several recommendations to lower costs for patients and the Medicare program by bringing payment parity for certain medical services […]

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