A recent opinion piece in The Hill, “Site-neutral payment reform is a winning issue for patients – unless Congress rolls it back,” paints an inaccurate picture of CMS’s site-neutral payment proposal, which is both bad policy and clearly undercuts Congressional intent to protect payments for hospital outpatient clinic visits and expanded services at certain off-campus hospital departments from cuts.

In criticizing the underlying policy behind payment differentials between hospital outpatient departments and independent physician offices, the author fails to make any mention of the crucial differences that persuaded Congress to support them. For example, hospitals provide 24/7 access to care for all patients, regardless of their ability to pay, are more likely to treat poorer and sicker patients and have to adhere to much higher and stricter regulatory standards.

The author reflexively blames consolidation in the oncology field on these policies rather than the constellation of larger market forces that have influenced many types of physician practices to seek a permanent relationship with their community hospital. And while hospitals share in the concerns about the rising costs of care, the real culprits continue to be the skyrocketing costs of prescription drugs, increased regulatory burden and the fact that Medicare and Medicaid continue to pay less than the cost of care.

The fact is that implementation of the site-neutral payment policies being proposed would be another blow, making it even more difficult for hospitals and health systems to find the resources to meet the ever-changing demands of caring for their patients and communities.   



Ashley Thompson is AHA Senior Vice President of Public Policy Analysis and Development