Managed Healthcare Executive October 11, 2023
Payers and hospitals are at odds over proposals that would level out payments to hospital outpatient departments and physician offices.
Healthcare costs are projected to soar in the coming years, and one proposed option to rein them in is to expand a model through which Medicare pays providers the same amount for the same service, whether it takes place at a hospital outpatient department or a doctor’s office.
“Initial signals are that Congress is interested in addressing payment differences across different outpatient settings,” says Eric Zimmerman, J.D., MBA, principal at McDermott+Consulting in Washington, D.C.
Current law requires Medicare to pay higher prices for services such as X-rays and lab work that are done at hospital outpatient departments rather than physician’s...
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