Ben Jones, vice president, Government Relations & Public Policy, McKesson Specialty Health, offers his thoughts on whether site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System will have positive implications for community practices.
Ben Jones, vice president, Government Relations & Public Policy, McKesson Specialty Health, offers his thoughts on whether site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System will have positive implications for community practices.
Transcript
In November, CMS finalized site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System. Do you think this change will have positive implications for community practices?
I do. This is one more step toward parity in reimbursement that is going to address this unleveled playing field that currently exists. This is something that often times results in consolidation. The closer we drive to site of service parity, the more we’re going to remove that incentive to consolidate community practices. The 2 things that I will say is that 1: unfortunately, this is something that is tied up in court and it’s very unlikely that Congress or the administration will expand on the policy until the court rules on this actual proposal. 2: unfortunately, what they’ve done by achieving parity in this manner is essentially brining costs down to the lowest common denominator. So, if you think about parity as a disparity in payment as it exists today, hospitals are here and community practices are here. Instead of finding a way to meet in the middle, what they’ve done is just bring everybody down here.
That’s obviously in an effort to show more cost savings from the government’s perspective, but often times that puts a heavier burden on the impacted hospitals, and that’s a conversation that still needs to be had. We don’t want to be in the practice of just taking money from hospitals for money’s sake. We think that the perceived incentives should be removed or we think that this incentive to consolidate should be removed by leveling the playing field, but we don’t want to put hospitals out of business, so let’s have a conversation. Whether that means we meet in the middle or whether that means there’s a separate conversation about overhead costs that hospitals have. Unfortunately, I don’t think any of those conversations will take place until the court actually acts on this proposal.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More