A group of organizations, including The US Oncology Network owned by McKesson, is urging Congress to enact site-neutral payment policies for services performed in hospital outpatient departments. The Alliance for Site-Neutral Payment Reform wants Medicare to pay HOPDs the same rates as physician offices. Other members of the group include the American Academy of Family Physicians, American College of Physicians, American Health Care Association, America's Health Insurance Plans, and Blue Cross and Blue Shield Association. President Obama’s fiscal year 2016 budget proposed reducing payments to providers by $29.5 billion by implementing site-neutral payment policies, and some groups want to use site-neutral cuts to hospitals to offset the cost of resolving the Sustainable Growth Rate for Medicare physician payment. A recent study prepared for the AHA showed that HOPDs treat sicker and poorer cancer patients in need of more extensive care and resources than do physician offices. The study also said that cancer patients treated in HOPDs have more severe chronic conditions and are about four times more likely to be uninsured or covered by Medicaid than are cancer patients treated in a physician’s office. In addition, the study warns that, to the extent differences in cancer patients and the care they receive in HOPDs and physician offices “result in variations in the cost of care, site-neutral payments may have adverse effects on patient access to care.”

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