AHA: Site-neutral Payments Ignore Hospitals’ Adverse Patient Mix

KEY TAKEAWAYS

Using data from 2019-2021, the study compared 511,000 medical claims for 263,000 Medicare beneficiaries using HOPD with 203,000 ASC claims from 127,000 Medicare beneficiaries.

AHA says the findings ‘underscore the reasons why compensating hospitals and health systems under Medicare the same amount as IPOs and ASCs could put patient access to care at risk.’

BCBSA wants to eliminate the 2015 exemption for some HOPDs, and adopt site-neutral policies and lower payment rates for routine services delivered outside the hospital—excluding rural hospitals.