On February 4, 2022, the Alliance for Site Neutral Payment Reform submitted the following recommendations to the Heathy Future Task Force Subcommittee on Affordability:
- Expand site neutral payments to all clinically appropriate outpatient services. The FY2020 President’s Budget called for expanding site neutral payments for all off-campus hospital-owned physician practices. This policy was projected to save approximately $28.7 billion over 10 years.
- Extend site neutral payments to Part B drug administration. More narrowly targeted than the above provision, this policy would immediately reduce out-of-pocket prescription drug costs for seniors because Medicare beneficiary cost-sharing is directly related to the Medicare payment rate for the drug and the administration of the drug. This policy is included in H.R. 19, the Lower Costs, More Cures Act of 2021.
- Improve Medicare site-of-service transparency. Modify the Medicare Outpatient Procedure Price Lookup tool to include information for services furnished in a physician office. This will empower patients to better understand the variations in cost by site of care and the impact on their out-of-pocket costs. This policy is also included in H.R. 19, the Lower Costs, More Cures Act of 2021.
The Alliance highlighted how the payment disparity between physician offices and hospital outpatient departments continues to grow, driving consolidation across the health care marketplace and increasing costs as care shifts into more expensive settings.
To read the full response, CLICK HERE.