MHE Question of the Week

We want to know what you’re thinking! Every Tuesday morning, the editors of Managed Healthcare Executive are posing a question to our readers about a timely issue in U.S. healthcare. We'll tally your answers and publish the results on Friday by 4 p.m. ET.

Some background on this week’s question

Payment for outpatient services has traditionally varied depending on where the services were delivered. Typically, they have been higher at hospital outpatient facilities than at physician offices. But as hospitals have bought physician practices and expanded their outpatient facilities, payers and others have pushed for “site-neutral” payment that pays the same amount for the service, regardless of where it is delivered. Medicare already has some site-neutral payment policies.

Now Congress and regulators are considering legislation and rules that would extend site-neutral payment further to include physician-administered drugs and outpatient facilities located on hospital campuses. Some proposals would also apply site-neutral payment rules to commercial payers.

Hospitals and some other groups are fighting site-neutral payment, arguing that patients seen in hospital facilities receive more coordinated care and are often more medically complex.