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6 key points on Medicare payments varying by site

Medicare payments for certain services can differ depending on where surgeons perform the procedure, according to MedPage Today.

Physicians Advocacy Institute commissioned the report and Avalere wrote the report.

Here are six key points:

1. The report's authors said a 40-day cardiac imaging episode performed in a physician office yielded a risk adjusted average Medicare payment of $655, compared to $2,078 for the same procedure performed in a hospital.

2. For a 22-day episode surrounding a colonoscopy, the risk-adjusted Medicare payment for a physician's office was $1,322 compared to $1,784 in a hospital outpatient department.

3. The PAI issued the report as it supports "fair and transparent payment policies and contractual practices by payers and others."

4. The report comes in the wake of Congress discussing how to best implement a new regulation enable site-neutral payments in specific instances. Healthcare stakeholders had until last week to send comments to the House Energy & Commerce Committee on the Bipartisan Budget Act of 2015, which included a section on implementing site-neutral payments for new hospital outpatient facilities in 2017.

5. Many opposed to the differences in payments argue it could lead to less competition among providers and hospital consolidation.

6. Tom Nickels, JD, American Hospital Association's executive vice president for government relations and public policy, voiced concerns over PAI's report. "Hospitals are inherently different from other sites of care, such as physician offices," he wrote in an email to MedPage Today. "Hospitals...must maintain standby services such as surgical suites, emergency departments, ambulance services, among others, that physician offices do not."

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