This issue brief describes five things to know about Medicare site-neutral payment reforms for outpatient services.
1. Medicare often pays more for the same service when provided in a hospital outpatient department versus other settings
2. While Congress enacted legislation in 2015 to align Medicare payments across settings in certain circumstances, there is interest in adopting additional site-neutral payment reforms
3. Site-neutral payment proposals vary in scope, with CBO estimates of savings ranging from less than $5 billion to more than $100 billion over ten years
4. Opponents say site-neutral reforms would adversely affect patient care
5. Site-neutral payment reforms could be designed to limit or offset the impact on certain providers, such as rural or safety-net hospitals