Health Affairs October 1, 2025
Abstract
Site neutrality in payment practices has become a salient issue in the US health care debate, as rising prices have brought increased pressure for policy action. Although Medicare has received disproportionate attention, these policies could also apply to commercial insurers, particularly to address payment differentials between hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). Using 2024 Transparency in Coverage data provided by Clarify Health on commercial prices for three insurers (UnitedHealthcare, Cigna, and BlueCross BlueShield), we compared payments for thirteen common procedures across settings. Overall, in 2024, commercial prices were $1,489 (78 percent) higher in HOPDs than in ASCs, whereas Medicare prices were $633 (97 percent) higher. However, site payment differentials varied substantially across payers: Cigna had the...
Today's Sponsors
Today's Sponsor