Site-Neutral Payments by CMS

[masterPain]

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Does anyone have any insight to this? Are ASCs the future?

Five Things to Know About Medicare Site-Neutral Payment Reforms | KFF

This brief examines key facts around proposals to align Medicare payments for outpatient services across care settings, otherwise known as “site-neutral payment reforms.”

www.kff.org

 

[nvrsumr]

@drusso

 

[SpineandWine]

Based on this article, office medicine is the future

 

[drusso]

@drusso

"

 

[Ducttape]

Based on this article, office medicine is the future

um, office medicine may get a boost but i dont get that same gestalt about office procedures, at least with regards to that article.

there seems to be nothing in that article that supports a push for office procedures. only to push HOPD procedures to pay the same as ASC.

if someone sees a line about our office based procedures being encouraged, let me know.

and peppered throughout are comments about patient safety. which makes me think, in typical government fashion, that some bureaucrat will want to institute JCAHO for office based procedures...

 

[Ducttape]

and before anyone flames me, i agree that site of service should not matter with office visits, patient appointments, trigger points, etc.

but i cant imagine HOPD or ASC lobbies would ever accept office based payments for injections and the like, however.



and all of these changes are skirting the main issue - the huge rise in healthcare costs is almost all on the administrative side, not the physician side.

 

[SpineandWine]

um, office medicine may get a boost but i dont get that same gestalt about office procedures, at least with regards to that article.

there seems to be nothing in that article that supports a push for office procedures. only to push HOPD procedures to pay the same as ASC.

if someone sees a line about our office based procedures being encouraged, let me know.

and peppered throughout are comments about patient safety. which makes me think, in typical government fashion, that some bureaucrat will want to institute JCAHO for office based procedures...

Higher Medicare payments for services provided in HOPDs than in freestanding physician offices create a financial incentive for hospitals to acquire physician practices, which could lead to higher costs.

I was reading between lines here and seeing general point of article was to equalize payments. This would bankrupt me as I made a huge investment into facilities (HOPD) and will be paying off debts for first 5-10 years

 

[drusso]

um, office medicine may get a boost but i dont get that same gestalt about office procedures, at least with regards to that article.

there seems to be nothing in that article that supports a push for office procedures. only to push HOPD procedures to pay the same as ASC.

if someone sees a line about our office based procedures being encouraged, let me know.

and peppered throughout are comments about patient safety. which makes me think, in typical government fashion, that some bureaucrat will want to institute JCAHO for office based procedures...

Office-Based Facility Association (OBFA) | coalition

Office-Based Facility Association (OBFA) is a coalition of office-based healthcare specialists working together to achieve payment stability in the Physician Fee Schedule.

www.obfassociation.org

 

[pmrmd]

and before anyone flames me, i agree that site of service should not matter with office visits, patient appointments, trigger points, etc.

but i cant imagine HOPD or ASC lobbies would ever accept office based payments for injections and the like, however.



and all of these changes are skirting the main issue - the huge rise in healthcare costs is almost all on the administrative side, not the physician side.

CMS could make some procedures non-payable in an HOPD. MBB, RF, ESI, SIJ could be ASC only. Most pain could be ASC only.

 

[BobBarker]

Yes, I could see that happening or site neutral for basic procedures for ASC/HOPD.

 

[A Deep Breath]

The hospital lobby is evidently much stronger than ours.

Even if the intention is to lower their payments to our level, I imagine it would mean a significant reimbursement increase for private practice with time.

 

[SpineandWine]

But HOPD gives higher level of service

 

[drusso]

The hospital lobby is evidently much stronger than ours.

Even if the intention is to lower their payments to our level, I imagine it would mean a significant reimbursement increase for private practice with time.

Why?

 

[masterPain]

Any idea when the bill will be presented in Washington? When would it go into effect?

 

[A Deep Breath]

[QUOTE="drusso, post: Why?[/QUOTE]

Hospitals have a strong lobby and they wouldn’t tolerate suddenly receiving a fraction of their previous reimbursement for lines of service they are heavily invested in.