Americans rely heavily on hospitals to provide 24/7 access to care for all types of patients, to serve as a safety net provider for vulnerable populations, and to have the resources needed to respond to disasters. Hospitals and their outpatient departments provide access to critical services that are not otherwise always available in the community, treat patients with more severe conditions than other sites of care, and are subject to more comprehensive licensing, accreditation, and regulatory requirements than other settings.

However, these roles and differences are not explicitly funded; instead, they are built into the overall hospital cost structure and supported by revenues received from providing direct patient care.

Yet some policymakers want to enact additional site-neutral payment cuts that would make total payment for a service provided in a hospital setting the same as when a service is provided in a physician office or ambulatory surgery center.

Payment proposals that attempt to treat hospital outpatient departments the same as these other ambulatory sites of care ignore this very different level of care provided by hospitals and the needs of the patients and communities cared for in that setting. Hospitals need to continue to provide emergency stand-by capacity, are open 24/7 to all who seek care regardless of ability to pay and have myriad regulatory requirements imposed on them – all adding to the overall cost of care.

AHA Position:

Congress should oppose additional site-neutral payment cuts, which would reduce access to critical health care services, especially in rural and other underserved communities.
 

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