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Would President Trump's budget proposal bring us closer to site-neutral payments?

President Donald Trump's White House proposed a new tax spending plan, outlining his priorities for the coming year in time for Congress to consider spending bills. The plan would increase military spending as well as fund the president's much-discussed border wall with Mexico, according to the Santa Fe Mexican.

But it also addresses healthcare spending, cutting $554 billion from Medicare spending over the next decade, even as the beneficiary population booms. The proposal also includes a provision that would cut the facility fees for medical practices owned by hospitals; this is expected to save the government $33.9 billion in 10 years.

The proposal affirms the fears of many low-cost providers when it comes to site-neutral payments; instead of marginally increasing payments to the lower cost provider — in this case the independent physician groups — the proposal would pay the physician rate to hospital-owned groups not located on the hospital's campus.

It's unlikely Mr. Trump's budget proposal will make it through Congress, but it shows legislators are paying attention to the site of service cost differential as they draft policies and legislation for the future.

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