Alliance for Site Neutral Payment Reform Applauds Site Neutral Policies in the

Republican Study Committee's FY 2019 Budget

The RSC budget calls for site neutral payments to apply to all off-campus care settings

Washington, DC, May 04, 2018 --(PR.com)-- The Alliance for Site Neutral Payment Reform submitted a
letter to the Republican Study Committee (RSC) commending the group for including site neutral policies
in the budget for fiscal year 2019. The policy, if adopted, would significantly lower Medicare spending
and patients' out-of-pocket costs, making the system more sustainable, while increasing patient access to
essential services.

Under current policy, hospital outpatient departments (HOPDs) are reimbursed at significantly higher
rates than independent physician practices for providing the exact same services. The result is increased
costs for patients, employers, and taxpayers.

“We commend the Republican Study Committee's FY19 budget for taking action to address this
continued imbalance by calling for the expansion of site neutral policies throughout the Medicare
program. This commonsense change to our healthcare delivery system would lower costs for patients,
provide savings and stability for the Medicare program and promote competition in the healthcare
marketplace,” the Alliance writes.

Because Medicare reimburses HOPDs at higher rates than community care clinics for providing the exact
same services, billions of taxpayer dollars are being wasted. According to reports from the Centers for
Medicare & Medicaid Services (CMS), the Government Accountability Office (GAO), and the National
Institute for Health Care Reform, both individual patients and the Medicare system as a whole pay more
when the same services are delivered in an HOPD setting instead of at a freestanding physician practice
for a wide variety of services, including: chemotherapy: $281 vs. $136[1]; cardiac imaging: $2,078 vs.
$655; colonoscopy: $1,383 vs. $625[2]; even a basic E/M visit costs $51 more when performed in a
HOPD. As a result, Medicare paid an additional $2.7 billion on services and patients spent $411 million
more in out-of-pocket costs over a three-year period when services were delivered in an HOPD.

The payment disparity is also driving the acquisition of community practices by hospitals, with more than
13,000 physician offices being converted into HOPD between July 2014 and January 2015 alone. While
the Bipartisan Budget Act of 2015 (BBA) helped stem the tide by aligning reimbursement rates for
HOPDs that have recently acquired physician practices, existing off-campus HOPDs are still exempt,
necessitating the pragmatic reforms in the RSC FY 2019 budget.

About the Alliance for Site Neutral Payment Reform

The Alliance for Site Neutral Payment Reform is a coalition of patient advocates, providers, payers and
employers who support payment parity across site of service in order to decrease Medicare and
commercial spending, ensure patients receive the right care in the right setting, lower taxpayer and
beneficiary costs and increase patient access. Our growing membership represents healthcare providers,

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patient and consumer groups, insurers and others who believe patients - and the healthcare system -
would be better served by policies that are fiscally wise and preserve and enhance care options. Learn
more at siteneutral.org.

[1] Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other
Revisions to Part B for CY 2018 (CMS-1676-P)

[2] Location, Location, Location: Hospital Outpatient Prices Much Higher than Community Settings for
Identical Services, The National Institute for Health Care Reform (NIHCR): Published online June 2014

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Contact Information:
Alliance For Site Neutral Payment Reform
Sarah Rhoades
703-548-0019
Contact via Email
http://www.siteneutral.org/

Online Version of Press Release:

You can read the online version of this press release at: https://www.pr.com/press-release/752862

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