CMS has finalized the new payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center Payment System (ASC).
Altogether, the changes would boost the OPPS payments 1.7 percent and ASC payments 1.9 percent in 2017.
But hospitals will not win everywhere. For example, the new OPPS rules exclude payments of certain outpatient services at inpatient levels at hospitals’ off-site facilities.
CMS said: “This payment differential has provided an incentive for hospitals to acquire physician offices in order to receive the higher rates. This acquisition trend and difference in payment has been highlighted as a long-standing issue of concern by Congress, the Medicare Payment Advisory Commission, and the Department of Health and Human Services Office of Inspector General.”
“We spoke to stakeholders across the outpatient community who care about the quality and value of care that Medicare patients receive,” said Sean Cavanaugh, CMS deputy administrator. “The policies finalized in today’s rule will not only improve the value of care provided to Medicare beneficiaries, but are also responsive to healthcare providers who are crucial to outpatient care.”
Physician groups have mostly supported “site-neutral payments” but many hospital leaders have strenuously opposed them for fear of losing money. The Bipartisan Budget Act passed by Congress last year essentially eliminated the payment disparities between different sites.
CMS also issued an interim final rule on the Medicare Physician Fee Schedule to address other payments received by off-campus hospital providers.
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