While hospitals oppose them, there is a strong need to enact comprehensive site neutral payment policies to lower costs in the healthcare system and to protect Americans hit by very high out-of-pocket payments.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the need for comprehensive site neutral payment policies. While hospitals oppose them, we need to lower costs in the healthcare system and protect Americans hit by very high out-of-pocket payments.
Key Takeaways:
Thus far, America has only made small advancements in site-neutral payment policies due to hospital opposition.
Site neutral payments reimburse the same rate for the same service regardless of outpatient location. They do not impact inpatient or emergency department reimbursement.
Hospital-owned facilities get paid higher fees just because they are owned by hospitals and create huge confusion in the marketplace when patients search for services. What’s more, providers are now dictating services at high-cost hospital-owned settings because they are increasingly employed by hospitals.
Higher hospital payments for services mean patients pay much higher out-of-pocket costs for routine services and surgeries.
In Medicare, hospital-affiliated outpatient sites receive 50% to five times more in payments than other settings.
In Medicare, only modest reforms have been passed and a much more comprehensive framework is needed.
If comprehensive site-neutral payments were passed, Medicare could save $145 billion over ten years.
Commercial payments are often linked to Medicare ones. As such, comprehensive reform would save the commercial world over $300 billion over ten years.
Hospital arguments that they are unique and deserve higher payments do not hold water. Site-neutral payments can be crafted to protect critical assets.
It is hard to feel sympathy for hospitals when they countenance much higher out-of-pocket costs for Americans and then sue them when they cannot afford to pay these exorbitant prices.
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Resources
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
