Congress passed legislation that would adopt site neutral payments for medical providers treating Medicare patients last fall, affecting off-campus hospital outpatient departments built or acquired after 2016, according to a report from The Hill, and savings to Medicare are at stake.
A new study from Avalere Health released by the Physicians Advocacy Group reported on the implications of the site-neutral patients. The researchers found:
1. The potential cost savings are huge; for example, Medicare pays three times as much for patients to undergo cardiac imaging at an HOPD instead of a physician's office. In 2011, around 7 million Medicare patients received echocardiograms.
2. While hospitals report patients who have treatment in the HOPD are sicker and older, the researchers adjusted their calculations for these risk factors and found that Medicare still spends more when patients receive care at the HOPD instead of the physician office for common services.
3. Patients undergoing colonoscopy with episode of care payments reported 35 percent higher cost at HOPD than physician offices. The evaluation and service management for new patients was 29 percent higher in HOPDs.
4. The study authors found care initiated at the hospital-owned facilities included more services and more costly services than compared with the physician offices from the initial service though the episode of care.
5. The researchers concluded Medicare would save significantly with site-neutral payments, and the site-neutral payment could curb the incentive for hospitals to acquire physician practices and build new satellite outpatient departments, according to the report.