What's Ahead for Site-Neutral Payments in Medicare and State Policies | AMCP Annual 2025

Site-neutral payments have become a significant topic in healthcare legislation, with growing discussions around their potential impact on cost savings and patient care.

While these legislative changes aim to reduce healthcare costs, they also raise concerns about how they could affect patients' access to care and their treatment outcomes.

At the AMCP 2025 annual meeting in Houston—running from March 31 to April 3—these areas were explored amongst professionals in attendance, particularly in the context of Medicare and commercial payers.

Sean Shirk, Pharm.D., director of specialty clinical solutions at Prime Therapeutics, addressed these key points in a session he co-presented, titled “Legislative Impacts on Site of Service: What is the Big Deal?”

Shirk presented the session alongside a Prime associate, Connie Estep, Pharm.D., BCGP, director of specialty clinical solutions.

During the presentation, Shirk addressed the challenges surrounding site-neutral payment policies and their effects on patient care.

He explained that while there has been little progress in this area with the new administration in Congress, the issue remains a high priority.

“I don’t think we’ve heard of it yet, but it’s still very early,” Shirk said. “We haven’t heard any word on whether or not things are going to be moving forward with the new administration or not.”

Shirk stressed the potential cost-saving benefits of site-neutral payments, more specifically in the space of hospital outpatient infusions, which can be much more expensive than alternative settings such as home infusion.

However, he also noted concerns that a focus on cost alone could overlook the importance of patient adherence and convenience.

“Patients are more adherent to their therapy when you lessen those barriers to access and you make it more convenient for them to have a nurse, for example, come to their home and perform the infusion versus them not even being aware that that exists due to site-neutral payment, where they're still going to the hospital outpatient facility, which costs them time, missed hours of work, etc.,” he said.

Shirk also noted that while some states, such as New York, have considered site-neutral payment legislation, no changes have been enacted yet.