The American Hospital Association has pushed back against proposed site-neutral payment cuts, arguing that they would reduce access to key healthcare services, particularly in rural and underserved communities.
Five things to know:
1. Hospital outpatient departments, such as hospital-owned clinics that provide complex cancer, pediatric and mental health services, should not be paid the same Medicare rate as standalone physician offices because HOPDs treat all patients who visit the facility, regardless of medical complexity or income level, according to the AHA.
2. The hospital association argues that HOPDs are also held to more stringent licensing, accreditation and regulatory requirements, and enacting site-neutral payments could force hundreds of outpatient clinics to end or cut back on certain services, resulting in job losses and reduced access to care.
3. HOPDs provide services that are not otherwise available in the community for vulnerable patient populations, according to the AHA. HOPDs are more likely to treat Medicare beneficiaries who have both more chronic conditions and more severe chronic conditions; are more likely to have a prior hospitalization and higher prior emergency department use; and are more likely to live in communities with lower incomes.
4. The hospital group also argues that site-neutral payment policies endanger hospitals' ability to provide 24/7 access to emergency care and standby capability and capacity for disaster response.
5. Treating services as the same regardless of the site of care dismisses the fact that only certain providers can care for the most acute, vulnerable and resource-intensive patients, according to the AHA. The group noted that hospital providers are also the sole source of a range of high-acuity services, including emergency and trauma care — the costs for which must be shared across all services.