Study Finds Hospital Outpatients Are Sicker and Tend to Come from Lower-Income Communities

NEW STUDY FINDS HOSPITAL OUTPATIENTS, INCLUDING CANCER PATIENTS, ARE SICKER AND TEND TO COME FROM LOWER-INCOME COMMUNITIES COMPARED TO PATIENTS TREATED IN INDEPENDENT PHYSICIAN OFFICES

 

WASHINGTON (September 25, 2018) – Medicare patients who receive care in a hospital outpatient department (HOPD) are more likely to be poorer and have more severe chronic conditions than Medicare patients treated in an independent physician office (IPO). 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 American Hospital Association by KNG Health Consulting LLC, highlight why 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.


“America’s hospitals and health systems are proud to provide care and emergency services 24/7 to all who come through the door regardless of their ability to pay,” said AHA President and CEO Rick Pollack. “But as this study clearly shows, the needs of the patients hospital outpatient departments care for each day are different from those who choose to be seen at an independent physician office. Proposals that treat them the same ignore the very different clinical and regulatory demands hospitals face, and could threaten access to care.” 
 

According to the study, relative to those seen in an IPO, Medicare patients, including cancer patients, seen in HOPDs are more likely to be:

  • From lower-income areas
  • Under 65 (individuals with disabilities, end-stage renal disease, and amyotrophic lateral sclerosis)
  • Burdened with more severe chronic conditions
  • Previously hospitalized
  • Eligible for both Medicare and Medicaid
  • Previously cared for in an emergency department, thereby having higher Medicare spending prior to receiving ambulatory care

 

In addition, hospitals are held to far higher regulatory standards because of the complexity of caring for these higher acuity patients.

 

For a full copy of the report, visit https://www.aha.org/guidesreports/2018-09-24-care-comparison-reports.

 

 

Contact:        

 

Marie Johnson, 202-626-2351, mjohnson@aha.org

Arika Trim, 202-626-2319, atrim@aha.org

 

###

 

About the AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.

Related Resources

Letter/Comment
Public
AHA letter to Representative Kilmer expressing support of H.R. 2552, the “Protecting Local Access to Care for Everyone Act.” 
Legal Documents
Introduction Plaintiffs’ opening brief explained the clear limits that Congress imposed on the ability of the Centers for Medicare & Medi
Guides/Reports
Public
This study examines how Medicare Fee-for-Service (FFS) beneficiaries receiving surgical care in HOPDs compare to those receiving care in ASCs.
Legal Documents
MINUTE ORDER resetting the briefing schedule after consideration of the parties' response to the Court's February 27, 2019 Minute Order.
Legal Documents
The parties to the above-referenced related actions respectfully submit this response to this Court’s minute order of February 27, 2019, which directed the…
Issue Brief