Amid rising issues about well being care spending and voters’ worries about well being care affordability, there may be rising, bipartisan curiosity in proposals to align Medicare funds for outpatient providers throughout care settings, in any other case often called “web site impartial” funds. The purpose of this method could be for Medicare to pay the identical price for a similar service, whether or not it’s offered in a hospital outpatient division (HOPD), ambulatory surgical heart (ASC), or freestanding doctor workplace, topic to affected person security and high quality safeguards. Personal payers may additionally obtain financial savings in the event that they undertake related cost insurance policies. Policymakers have been focusing lately on site-neutral cost reform in response to issues about well being care prices and the fast tempo of consolidation, on condition that the variations in cost throughout settings for a similar service create a monetary incentive for hospitals to amass doctor practices.
Web site-neutral cost reforms would decrease prices by lowering the quantity Medicare pays for sure providers when carried out in costlier settings and will additionally decrease prices by lowering incentives for hospitals to purchase up doctor practices, a sample which has additionally been related to larger industrial costs. By means of laws and rulemaking, Medicare has moved incrementally ahead by aligning funds for clinic visits offered at off-campus HOPDs and for all different providers offered at off-campus HOPDs that began billing on or after November 2, 2015, with some exceptions. Some policymakers are urgent to broaden the attain of site-neutral cost reforms to incorporate further settings, resembling on-campus HOPDs and off-campus HOPDS that had been grandfathered and exempted from sure site-neutral funds underneath present regulation. In December 2023, for instance, the Home of Representatives handed the Decrease Prices, Extra Transparency Act on a bipartisan foundation, which might align Medicare funds for drug administration providers in off-campus HOPDs, together with these exempt underneath prior reforms.
Opponents, principally within the hospital business, argue that site-neutral cost reforms would adversely have an effect on sufferers’ entry to providers by lowering hospital revenues, elevating explicit issues about entry for rural and low-income populations. Additionally they counsel that the upper funds for providers in hospital outpatient settings are justified by the extent of care sufferers want, the upper prices of offering care in hospitals (e.g., attributable to regulatory necessities), and the prices of sustaining emergency care and standby capability.
This difficulty temporary describes 5 issues to find out about Medicare site-neutral cost reforms for outpatient providers. It doesn’t talk about a associated set of proposals to control outpatient facility charges charged by hospitals and different institutional suppliers in industrial markets, resembling a invoice launched within the Senate. These choices are meant to realize related coverage objectives however are extra difficult, partially, as a result of costs in industrial markets are decided by means of negotiations between payers and suppliers slightly than being set by the federal government.
1. Medicare typically pays extra for a similar service when offered in a hospital outpatient division versus different settings
Conventional Medicare usually pays extra for outpatient providers when offered in HOPDs than in ASCs or freestanding doctor workplaces—which is normally the least-expensive setting. For instance, one report estimated that funds for preliminary preventive exams had been 51 % larger in 2023 when offered in an HOPD than in a freestanding doctor workplace, primarily based on nationwide cost quantities. One other estimated that common reimbursement for drug administration providers was 129 to 211 % larger in HOPDs than in freestanding doctor workplaces in 2021. (Each units of quantity exclude HOPDs which are topic to present site-neutral reforms).
Medicare usually pays the identical quantity for providers offered by HOPDs whether or not the HOPD is on the principle campus of the hospital—i.e., “on-campus”—or off-campus. Off-campus HOPDs typically resemble doctor workplaces and will have beforehand been freestanding doctor workplaces that had been acquired by a hospital.
Hospital outpatient division (HOPD). Below the usual reimbursement method, Medicare makes one cost to the hospital underneath the outpatient potential cost system (OPPS)—typically known as a “facility payment”—and a separate cost to clinicians utilizing the doctor payment schedule (PFS) price for facility settings. Some hospitals are excluded from the OPPS, resembling vital entry hospitals (CAHs), which obtain cost-based reimbursement.
Ambulatory surgical heart (ASC). Medicare usually makes use of an analogous method to reimburse providers offered in ambulatory surgical facilities (ASC) because it does for providers offered in HOPDs however with a facility payment that’s decrease than the OPPS price.
Freestanding doctor workplace. Medicare makes a single cost to the clinician utilizing the doctor payment schedule (PFS) price for nonfacility settings.
*Conventional Medicare makes use of the identical cost system throughout settings for outpatient remedy providers, mammography checks, dialysis providers, and scientific lab checks. Supplier reimbursement underneath Medicare Benefit is negotiated between plans and suppliers, is just not public, and will or could not differ from conventional Medicare charges.
Variations in Medicare funds throughout settings lead to larger prices for Medicare and its beneficiaries. Variations in Medicare funds imply that, by definition, program spending is larger than it might have been if this system reimbursed for providers primarily based on the least-expensive setting. Larger Medicare spending results in larger Half B deductibles and cost-sharing quantities in conventional Medicare. For instance, MedPAC estimated that aligning Medicare cost charges for a set of outpatient service classes (described beneath) would have diminished whole conventional Medicare Half B spending by $6.0 billion in 2021 and beneficiary price sharing by $1.5 billion. Larger Half B spending would additionally contribute to larger premiums for beneficiaries, as a result of Medicare premiums are primarily based on whole Half B spending.
Financial savings for beneficiaries attributable to site-neutral cost reforms would range, partially, relying on the quantity of outpatient providers they use and the place they obtain their care. For example, one current examine estimated that aligning reimbursement for drug administration providers between off-campus HOPDs and freestanding doctor providers would have diminished price sharing for conventional Medicare beneficiaries by about $1 on common in 2021 however $1,055 amongst beneficiaries with the best use of chemotherapy who obtain care at off-campus HOPDs that aren’t topic to present site-neutral reforms (along with lowering the usual Half B premium by about $1).
As with Medicare, costs paid by personal plans for outpatient providers can even range throughout care settings. Analysis from the Blue Cross Blue Protect Affiliation discovered that common costs paid for a big industrial inhabitants had been 31% larger for clinic visits in 2022 when offered in an HOPD versus a freestanding doctor workplace, 238% larger for chest x-rays, and 563% larger for prostate biopsies, amongst different variations. These variations may partially replicate Medicare’s reimbursement system to the extent that industrial payers are benchmarking to Medicare charges.
Larger industrial costs attributable to variations in funds by web site of care result in larger prices for employers, larger premiums and price sharing for staff and different well being plan enrollees, and doubtlessly larger spending or decrease revenues for the federal authorities. A CBO report discussing insurance policies to cut back industrial costs acknowledged that they’d “would primarily have an effect on the price range by decreasing federal subsidies for medical insurance.”
Larger Medicare funds for providers offered in HOPDs than in freestanding doctor workplaces create a monetary incentive for hospitals to amass doctor practices, which may result in larger prices. Each the CBO and MedPAC have noticed that Medicare’s reimbursement system creates an incentive for hospitals to amass doctor practices. Doing so permits suppliers to invoice Medicare on the larger charges for a similar providers when offered in an HOPD, resulting in larger prices. Some research present proof that variations in funds throughout settings have led to will increase in consolidation of doctor practices with hospitals and that consolidation has led to larger spending in Medicare and industrial markets, with unclear results on high quality.
2. Whereas Congress enacted laws in 2015 to align Medicare funds throughout settings in sure circumstances, there may be curiosity in adopting further site-neutral cost reforms
Proponents say that site-neutral cost reforms would scale back Medicare program and beneficiary spending, result in spillover results that scale back spending in industrial markets, and additional lower industrial costs by slowing the tempo of consolidation. By means of laws and rulemaking, Medicare has aligned funds for clinic visits at off-campus HOPDs in addition to for all different providers at off-campus HOPDs that began billing on or after November 2, 2015, with some exceptions. Extra lately, policymakers have expressed some curiosity in making use of these reforms to further providers and settings, primarily based on Congressional hearings and laws that handed the Home of Representatives in 2023.
The Bipartisan Finances Act (BBA) of 2015 launched site-neutral cost reforms for providers offered at comparatively new off-campus HOPDs. Below this modification, Medicare started to pay for providers in some HOPDs at a decrease quantity extra carefully aligned with what could be paid in a freestanding doctor workplace. The BBA provisions utilized to off-campus HOPDs that began to invoice Medicare underneath the OPPS on or after the date that the regulation was enacted (November 2, 2015), whereas grandfathering off-campus HOPDs that existed and billed earlier. The BBA of 2015 and subsequent laws (the twenty first Century Cures Act of 2016) created further exemptions for off-campus HOPDs, together with for these which are devoted emergency departments, are associated to a devoted most cancers hospital, or had been underneath building when the BBA was enacted. Below present regulation, exempt off-campus HOPDs are permitted to invoice underneath the OPPS for brand new providers offered, for instance, because of incorporating further doctor practices.
In 2015, the CBO estimated that the BBA site-neutral cost reforms would save about $9 billion over ten years. CMS carried out this reform by lowering facility charges for affected providers to 50% of OPPS charges starting in 2017 and to 40% starting in 2018, with the intent of aligning cost in these settings with freestanding doctor workplaces.
In follow, this reform has been comparatively modest in scope. In keeping with MedPAC, providers offered in non-exempt off-campus HOPDs and paid at decrease quantities account for lower than one % of all OPPS spending.
In 2019, CMS prolonged Medicare’s site-neutral funds to cowl clinic visits in any respect off-campus HOPDs that submit claims to Medicare underneath the OPPS. This contains all off-campus HOPDs that had been exempt underneath the BBA of 2015. CMS diminished the power part of reimbursement for clinic visits to 40% of OPPS charges, which it meant to part in over 2019 and 2020. Implementation was quickly interrupted when the American Hospital Affiliation (AHA) and others filed a lawsuit in opposition to the Division of Well being and Human Providers, arguing that CMS had exceeded its authority. Nonetheless, a federal appeals court docket rejected the business’s declare in 2020 and the Supreme Courtroom declined to contemplate an attraction in 2021, which allowed CMS to totally implement the rule. In 2022, CMS introduced that rural sole group hospitals could be exempted from this site-neutral cost reform starting in 2023.
Two-thirds of HOPD clinic visits are offered in on-campus HOPDs and so aren’t topic to the decrease charges.
Given the restricted attain of present site-neutral cost insurance policies, MedPAC and others have really useful that Congress implement further site-neutral reforms for outpatient providers. MedPAC’s suggestion is that Congress “extra carefully align cost charges throughout ambulatory settings for chosen providers which are secure and applicable to supply in all settings and when doing so doesn’t pose a threat to entry,” with CMS selecting the providers. MedPAC offered one method that will align HOPD and ASC cost charges with freestanding doctor workplaces for 57 service classes which are mostly offered in that setting, which the Fee views as a sign that they are often safely offered there. This contains providers resembling clinic visits, drug administration, and sure imaging providers. MedPAC’s method would additionally align HOPD cost charges with ASCs for 9 service classes which are mostly offered in that setting, resembling sure kinds of colonoscopies. The method would improve aligned funds when associated to emergency visits or trauma care. Web site-neutral cost reforms have additionally been endorsed by teams from throughout the political spectrum— together with Households USA, Individuals for Prosperity, the Bipartisan Coverage Heart, and former Secretaries of Well being and Human Providers (HHS) Kathleen Sebelius and Alex Azar—in addition to by the Authorities Accountability Workplace and the HHS Workplace of Inspector Common.
In December of 2023, the Home of Representatives handed laws to use Medicare site-neutral funds to medication administered in an outpatient setting. The Home of Representatives handed the Decrease Prices, Extra Transparency Act (320-71) in December 2023, which might align Medicare funds for drug administration providers—resembling for chemotherapy—in off-campus HOPDs with charges for freestanding doctor workplaces. Policymakers have thought of a wide range of different proposals, together with proposals to use site-neutral reforms to most cancers prognosis and remedy providers at off-campus HOPDs, all providers offered at off-campus HOPDs, or providers offered in any respect HOPDs (off-campus and on-campus) and ASCs when they’re mostly offered in inexpensive settings, resembling freestanding doctor workplaces (consistent with the MedPAC method). Former President Trump’s 2021 price range proposal included comparatively broad site-neutral cost reforms (as described beneath). President Biden didn’t embody related proposals within the Administration’s budgets for 2022 by means of 2025.
Regardless of bipartisan curiosity, and a Home-passed invoice, site-neutral cost reforms had been thought of however finally excluded from a authorities spending bundle that was enacted in March 2024. Proponents are pushing for these reforms to be included in a year-end spending bundle.
3. Web site-neutral cost proposals range in scope, with CBO estimates of financial savings starting from lower than $5 billion to greater than $100 billion over ten years
Estimated financial savings from proposed site-neutral cost reforms range broadly (see Determine 1). For instance, CBO estimated that the supply within the Decrease Prices, Extra Transparency Act that will align funds for drug administration providers in off-campus HOPDs would save $4 billion over ten years. In distinction, of their analysis of former President Trump’s 2021 price range proposal, CBO estimated {that a} proposal to increase reforms to all providers in off-campus HOPDs would have saved $39 billion over ten years. The Trump price range proposal to align funds for on-campus HOPDs for providers generally offered in non-hospital settings would have saved $102 billion over ten years. Variations in financial savings to the federal government would additionally correspond to various financial savings for beneficiaries.
Massive variations in anticipated financial savings replicate the various scope of site-neutral cost reforms:
Which internet sites of care are coated? Proposals range primarily based on whether or not they would apply to off-campus HOPDs alone or all HOPDs. Web site-neutral cost reforms for a given set of providers may result in considerably bigger financial savings in the event that they had been additionally utilized to on-campus HOPDs. One examine estimated that on-campus HOPDs accounted for 87 % of Medicare’s spending on hospital outpatient providers in 2022 and, as famous above, on-campus HOPDs account for two-thirds of clinic visits offered at HOPDs. One other examine estimated that aligning funds for the providers recognized by MedPAC would save Medicare $18 billion over ten years if utilized to off-campus HOPDs alone however $127 billion over ten years if on-campus HOPDs had been additionally included.Nonetheless, most reforms have targeted on off-campus HOPDs, which can be much less controversial on condition that off-campus HOPDs typically resemble doctor workplaces (and will have been freestanding doctor workplaces that had been acquired by a hospital). Whereas a number of choices would align charges in HOPDs with freestanding doctor workplaces, some would align charges in HOPDs with ASCs and in ASCs with freestanding doctor workplaces for sure providers, leading to further financial savings.
What providers could be coated? Proposals range within the providers that will be coated, which in flip impacts the estimated financial savings. For instance, proposals regarding off-campus HOPDs range in whether or not they would align cost for most cancers prognosis and remedy, drug administration (estimated by one group to avoid wasting Medicare $5 billion over ten years), providers mostly offered in inexpensive settings as recognized by MedPAC (estimated to avoid wasting $18 billion over ten years), or all providers (estimated to avoid wasting $28 billion over ten years). Current proposals regarding on-campus HOPDs have targeted on providers generally offered outdoors of hospitals. Proposals additionally range by way of whether or not they would carve out or increase funds for providers associated to emergency care or which are offered in devoted emergency departments.
Which suppliers could be given particular consideration or exempted? Proposals range in whether or not they embody provisions to restrict or offset the influence on sure suppliers, resembling by excluding rural hospitals, capping losses for hospitals that look after a comparatively giant variety of low-income sufferers, or focusing on new assets to safety-net or rural hospitals.
Are proposals designed to be price range impartial? Web site-neutral cost reforms are sometimes designed to cut back authorities spending however could possibly be pursued in a price range impartial method. For instance, MedPAC famous that its suggestion to Congress wouldn’t have an instantaneous impact on whole OPPS spending attributable to price range neutrality necessities underneath present regulation, which might lead to offsetting will increase in reimbursement for hospital outpatient providers that aren’t affected by site-neutral reforms. Nonetheless, insurance policies which are carried out in a price range impartial trend could nonetheless decrease Medicare spending over time by lowering the inducement for hospitals to amass doctor practices.
Timing. Proposals range in how shortly they’d be carried out and whether or not they could be phased in over time.
Some site-neutral reform proposals would require that off-campus HOPDs present a separate, distinctive identifier from the principle campus when submitting claims, which is predicted to provide modest financial savings. This provision would make it simpler for personal insurers to establish and prohibit facility charges and will enhance the accuracy of Medicare funds to off-campus HOPDs. CBO estimated that one model of this proposal would scale back federal spending by about $2 billion over ten years, primarily by means of its impact on industrial markets.
4. Opponents say site-neutral reforms would adversely have an effect on affected person care
Critics of site-neutral cost reforms, primarily hospital business representatives, have voiced concern in regards to the seemingly influence on hospital revenues and affected person care. Opponents warn that decreases in Medicare reimbursement attributable to site-neutral reforms may lead some hospitals to cut back or remove providers that they provide in HOPDs or different departments. Simply as reforms may result in financial savings for the federal government and sufferers, they may additionally result in decreases in revenues for hospitals. For instance, MedPAC estimated that its method—i.e., aligning funds for providers offered in on- and off-campus HOPDs and ASCs which are largely generally offered in less-expensive settings—would scale back Medicare revenues amongst OPPS hospitals by about 3.8% if carried out with out price range neutrality necessities. Critics say that the income losses could be particularly difficult for hospitals in mild of economic challenges dealing with the sector, together with larger prices attributable to labor shortages. Hospital employment now exceeds pre-pandemic ranges, and business experiences point out that funds have been bettering, although some hospitals proceed to wrestle.
Income losses could be bigger for some hospitals than for others. For instance, MedPAC estimated that its method would result in comparatively giant decreases in Medicare revenues for smaller and rural hospitals. Different analysis has discovered that off-campus HOPDs—the main target of some reforms—account for a smaller share of whole hospital or facility outpatient revenues in rural versus city areas. Relatedly, in line with analysis supported by the AHA, Medicare beneficiaries handled in HOPDs are extra seemingly than these handled in doctor workplaces to be dual-eligible people.
The potential influence of site-neutral cost reforms on rural hospitals has been a sticking level for some Members of Congress amid broader issues in regards to the monetary stability of those amenities. As described beneath, some have proposed choices which are meant to melt the influence on hospital funds and mitigate entry issues. Earlier site-neutral cost reforms and plenty of proposals to increase upon these reforms don’t apply to Crucial Entry Hospitals (CAHs)—that are usually in rural areas—as a result of these amenities are reimbursed by Medicare underneath a separate cost system.
Critics of site-neutral cost reforms say that larger cost charges for outpatient hospital providers are justified by larger overhead prices (together with these attributable to stricter regulatory necessities for hospitals) and better prices related to sustaining sure important providers, together with 24/7 emergency care and standby capability for public well being crises and different emergencies. Proponents counter that charges shouldn’t be primarily based on hospital prices however on the prices of offering the service within the least-expensive setting that’s secure and applicable. Some have proposed to refine funds to supply a mechanism to pay for emergency care and standby providers, slightly than constructing in the price of these providers by means of larger reimbursement for outpatient providers extra usually.
Opponents of site-neutral cost reforms have additionally prompt that reimbursement needs to be larger for HOPDs as a result of they look after sufferers with extra complicated care wants who’re extra pricey to deal with. For instance, analysis supported by the AHA discovered that Medicare beneficiaries handled in HOPDs are extra seemingly than these handled in doctor workplaces to have a serious complication and comorbidity or have had a current emergency division go to or hospital keep. Nonetheless, one other evaluation discovered that variations in affected person severity throughout HOPDs and doctor workplaces are small. MedPAC has additionally famous that the providers they’ve targeted on usually have low complexity—and will not essentially price extra to supply for sicker sufferers—and that hospitals can typically invoice for added providers underneath the OPPS if sufferers want them.
As well as, doctor teams and others counsel that Medicare reimbursement charges underneath the doctor payment schedule—i.e., the idea for aligned cost charges—are insufficient. The preponderance of analysis finds that Medicare beneficiaries shouldn’t have issues accessing clinicians, though the AHA argues that hospital acquisitions of doctor practices have helped protect entry. Some have raised the choice of utilizing financial savings from site-neutral reforms to extend cost charges for physicians, which may assist to mitigate these issues.
5. Web site-neutral cost reforms could possibly be designed to restrict or offset the influence on sure suppliers, resembling rural or safety-net hospitals
To deal with issues in regards to the impact of site-neutral cost reforms on hospital funds and the implications for entry to care and high quality, policymakers may embody provisions that restrict or offset the influence on weak hospitals, resembling rural or safety-net hospitals. Choices embody the next:
Use financial savings to fund focused help to weak hospitals. Examples of focused help embody rising reimbursement for rural or safety-net hospitals for providers, delaying scheduled cuts to Medicaid Disproportionate Share Hospital (DSH) funds, rising and bettering the focusing on of Medicare uncompensated care and DSH funds, extending Medicare cost designations for Medicare Dependent Hospitals and Low-Quantity Hospitals, increasing Medicare Crucial Entry Hospital (CAH) designations to further amenities, and investing within the rural well being care workforce.
Cap losses for weak hospitals. Another method would restrict the discount in Medicare revenues to a specified % for any given hospital assembly sure standards (e.g., that look after a comparatively giant share of low-income beneficiaries) on a brief or everlasting foundation. One tradeoff of this method is that it might retain among the incentives underneath Medicare’s present reimbursement system to amass doctor practices, because the impact of the reform could be eradicated above the cap. One method for addressing this may be to calculate what the offset would have been previous to implementation after which utilizing that quantity as the idea for future offsets (which might due to this fact not be affected by later acquisitions).
Exclude sure hospitals altogether. Earlier site-neutral cost reforms and plenty of proposals to increase upon these reforms don’t apply to CAHs, which accounted for 61 % of rural hospitals in 2021. Former President Trump’s 2021 price range proposal would have excluded rural hospitals from proposed site-neutral reforms for on-campus HOPDs, with out defining how broadly this exemption could be utilized. Excluding hospitals would scale back the financial savings, though extending the coverage to on-campus HOPDs produces considerably bigger financial savings than insurance policies which are restricted to off-campus HOPDs. One examine estimated that off-campus HOPDs affiliated with rural amenities would account for about six % of conventional Medicare program and beneficiary financial savings underneath the Decrease Prices, Extra Transparency Act’s site-neutral cost reform. The tradeoff of excluding rural hospitals altogether is that it might essentially remove the potential advantages of site-neutral cost reform for rural areas, resembling decrease spending for beneficiaries and diminished consolidation.
Ambulatory surgical heart (ASC). ASCs are distinct well being care suppliers that largely present outpatient surgical procedures to sufferers who don’t want to remain in a single day.
Crucial entry hospital (CAH). Greater than 1,300 hospitals are designated as a CAH by Medicare on the idea of getting 25 or fewer beds and assembly different necessities. Medicare reimburses CAHs primarily based on prices, slightly than underneath the inpatient or outpatient potential cost programs. CAHs are usually in rural areas.
Facility payment. Charges charged by hospitals and different institutional suppliers that are supposed to cowl the operational prices of working the power. These are distinct from skilled charges for the care offered by physicians and different well being care professionals.
Freestanding doctor workplace. Freestanding doctor workplaces function independently from a hospital. Providers in freestanding doctor workplaces are reimbursed by Medicare utilizing the doctor payment schedule (PFS). When a hospital acquires a freestanding doctor workplace, the identical providers could be billed underneath Medicare’s reimbursement system for care offered in hospital outpatient departments, which usually leads to larger funds. In that state of affairs, Medicare makes a cost to the clinician underneath the PFS at a price that’s usually decrease than for freestanding doctor workplaces but additionally makes a separate cost to the hospital underneath the outpatient potential cost system (OPPS).
Hospital outpatient division (HOPD). Hospital departments that present outpatient providers, resembling clinic visits, injections, and outpatient surgical procedures. There was a big improve in Medicare spending on HOPD providers over time as care has shifted from inpatient to outpatient settings and as hospitals have acquired doctor practices and instantly employed extra physicians.
Off-campus HOPD. HOPDs that aren’t a part of the hospital campus (i.e., aren’t bodily near the principle hospital buildings). Off-campus HOPDs typically resemble physicians’ workplaces and will have beforehand been freestanding doctor workplaces that had been acquired by a hospital.
On-campus HOPD. HOPDs which are a part of the hospital campus (i.e., are a part of or bodily near the principle hospital buildings).
Outpatient potential cost system (OPPS). The cost system that Medicare usually makes use of to cowl hospitals’ prices for HOPD providers, resembling for nursing providers, medical provides, gear, and rooms. OPPS charges range geographically and primarily based on the complexity of the service, amongst different issues. Medicare additionally supplies a separate cost to clinicians underneath the PFS for providers offered in an HOPD.
Doctor payment schedule (PFS). Medicare’s cost system for doctor and different well being care skilled providers. This accounts for clinicians’ labor, follow bills (resembling for lease, gear, and workers), and malpractice insurance coverage. The PFS contains separate charges for facility and nonfacility settings. The PFS price for providers offered in HOPDs (the speed for facility settings) is usually smaller than for providers offered in freestanding doctor workplaces (the speed for nonfacility settings), which displays the truth that HOPDs cowl many bills in any other case incurred by clinicians in freestanding workplaces and are reimbursed for these prices underneath the OPPS.
This work was supported partially by Arnold Ventures. KFF maintains full editorial management over all of its coverage evaluation, polling, and journalism actions.
