Site-neutral payments aim to charge the same wherever a service is provided. Hospitals are unfairly treated as a result of such payments because of the unique services they provide, according to Rick Pollack, CEO of the American Hospital Association.
Writing in The Hill July 2, Mr. Pollack outlines five reasons why such payments don't work and why "now is not the time to expand flawed policies that undermine the unique services hospitals provide for their patients."
- Patients, particularly those in rural and medically underserved communities, could lose access to local hospital care if inadequate reimbursement leads to closures.
- Such payments are based on a flawed assumption that hospitals are overpaid for outpatient services. In reality, Medicare outpatient margins are a "staggering" -17.5 percent at a time when hospital expenses have grown 17.5 percent in recent years.
- Patients of hospital outpatient departments tend to be sicker and lower income with complex chronic conditions compared with people seeking care in ambulatory surgery centers or physician offices.
- Such site-neutral payments fail to take into account key differences between hospital outpatient centers and other sites of care. There are more restrictive licensing, accreditation and other regulatory requirements for hospitals, for example.
- Health insurers and private equity firms — not hospitals — are responsible for most of the acquisition of physicians during the last five years
"Congress should reject these harmful proposals, and instead work to strengthen access to essential care for patients and communities across the nation," Mr. Pollack said.