MEDPAC pol­icy high­lights $900 mil­lion in an­nual sav­ings

Modern Healthcare - - LATE NEWS -

Congress may be sali­vat­ing over a long list of op­por­tu­ni­ties to cut hos­pi­tals’ out­pa­tient ser­vices. In March 2012, the Medi­care Pay­ment Ad­vi­sory Com­mis­sion said the govern­ment could save as much as $1 bil­lion a year by pay­ing a uni­form rate for eval­u­a­tion and man­age­ment of­fice vis­its, re­gard­less of whether they take place in a hos­pi­tal’s out­pa­tient set­ting or a physi­cian’s of­fice. MedPAC fol­lowed that Fri­day with a re­port of­fer­ing an­other 66 am­bu­la­tory pay­ment ar­eas where a “site-neu­tral” pol­icy could de­rive big sav­ings, per­haps an­other $900 mil­lion a year. “We have a real in­ter­est in that area,” Rep. Kevin Brady (R-Texas), chair­man of the Ways and Means Health Sub­com­mit­tee, said dur­ing a hear­ing on the re­port. The changes would ac­com­plish $500 mil­lion of the pro­jected an­nual sav­ings from three groups of car­diac imag­ing ser­vices. MedPAC also noted that the use of such imag­ing among Medi­care ben­e­fi­cia­ries has shifted from of­fice set­tings to hos­pi­tal out­pa­tient de­part­ments as hos­pi­tals are em­ploy­ing more car­di­ol­o­gists. Mark Miller, ex­ec­u­tive di­rec­tor of MedPAC, tes­ti­fied that the higher hos­pi­tal-based rates aren’t jus­ti­fied and are caus­ing un­in­tended con­se­quences. “We think that pay­ment has stim­u­lated pur­chases of physi­cian prac­tices, for ex­am­ple,” he said. The Amer­i­can Hos­pi­tal As­so­ci­a­tion tried to get MedPAC to strike the pro­pos­als from its June re­port to Congress. The trade group es­ti­mated that all of the site-neu­tral changes would cost hos­pi­tals more than $2 bil­lion an­nu­ally. “Given the com­plex­ity in­volved in craft­ing a siteneu­tral pay­ment pol­icy, the AHA be­lieves that a more ro­bust anal­y­sis of im­pact should have been con­ducted be­fore this is­sue was com­mit­ted to a pub­lished chap­ter,” said Marie Wat­teau, an AHA spokes­woman.

— Rich Daly

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