AHA study finds HOPDs treat sicker patients than independent physician offices

The AHA Sept. 3 released a study conducted by KNG Health Consulting that found Medicare patients who receive care in a hospital outpatient department are more likely to come from geographically isolated and medically underserved communities and be sicker and more complex to treat than Medicare patients treated in independent physician offices. Specifically, the study found that Medicare patients who are seen in HOPDs — including those with cancer — are more likely to be from rural and lower-income areas, living with more severe chronic conditions, dually-eligible for both Medicare and Medicaid, previously hospitalized or cared for in a hospital emergency department, and under 65 and eligible for Medicare based on disability.

“Hospitals play a unique and irreplaceable role in caring for patients in all communities but especially in rural and other medically underserved areas,” said AHA President and CEO Rick Pollack. “Current Medicare payment rates appropriately recognize the fundamental differences between patient care delivered in hospital outpatient departments compared to other settings, including around-the-clock services and emergency care. However, efforts to expand site-neutral payment cuts disregard the realities of our health care system and will result in limiting or eliminating critical hospital-based care. The result will be increased wait times and reduced access to care for all patients.”