Researchers conducted a study to assess whether fix-amount fee schedules or percent-of-charge-based fee regulations impacted hospital outpatient payments per surgical episode.
Here's what they found:
1. Connecticut adopted a fee schedule for hospital and ambulatory surgery center services, setting the HOPD rate at 210 percent of the Medicare rate. When the state introduced the ambulatory payment classification based fee schedule, the average hospital outpatient payment per surgical episode fell by 14 percent from 2014 to 2015.
2. In 2015, states with percent-of-charge-based fee regulation rates for hospital outpatient payments per surgical episode were between 37 percent and 151 percent higher than the median of states with fixed-amount fee schedules.
3. States lacking fee schedules had between 44 percent and 136 percent higher hospital outpatient payments per episode than states with fixed-amount fee schedules in 2015.