AHA study shows HOPDs treat sicker, poorer patients than independent physician offices
Medicare patients who receive care in a hospital outpatient department are more likely to be poorer and have more severe chronic conditions than Medicare patients treated in an independent physician office, according to a study released today by the AHA. The study also specifically examined the characteristics of Medicare cancer patients seen in HOPDs and IPOs and found similar results.
The findings of this new study, conducted for the AHA by KNG Health Consulting LLC, highlight why actions implemented in the last few years by the Department of Health and Human Services, as well as other proposals under consideration by Congress to reimburse hospitals the same amount as physician offices, could threaten access to care for the most vulnerable patients and communities.
The AHA, joined by member hospitals and health systems and other national organizations representing hospitals, in February filed a petition asking the U.S. Supreme Court to reverse an appeals court decision challenging HHS’ payment reductions in the 2019 outpatient payment rule for certain hospital outpatient off-campus provider-based departments. A lower court twice found that HHS exceeded its statutory authority when it reduced these payments; however, in July, a three-judge appeals panel reversed this decision.