Advocacy Issue: Site-Neutral Payment Proposals

The Issue

Hospitals and their associated facilities provide access to critical services that are not otherwise always available in the community and they treat patients with very severe conditions. Payment proposals that attempt to treat hospital outpatient departments the same as independent physician offices and other ambulatory sites of care ignore the very different level of care provided by hospitals and the needs of the patients and communities cared for in that setting. Hospitals need to have emergency stand-by capacity, are open 24/7 to all who seek care regardless of ability to pay, and have myriad regulatory requirements imposed on them – all adding to the overall cost of care.

AHA Position

Congress should oppose site-neutral payment cuts, which would reduce access to critical health care services, especially in rural and other underserved communities.

Key Resources

• UPDATED: Fact Sheet: Medicare Hospital Outpatient Site-Neutral Payment Policies
• Fact Sheet: Hospital Outpatient Department Billing Requirements
• Myth vs Fact: Site-neutral Payment Policies Infographic
• Fact Sheet: Facility Fees 
• Analysis: Hospitals and Health Systems Are Critical to Preserving Access to Care for Rural Communities
• Infographic: Medicare Significantly Underpays Hospitals for Cost of Patient Care
• National and State Impacts of Site-neutral Provisions in the Lower Costs, More Transparency Act (H.R. 5378)
• Chart: Reject Site-Neutral Payment for Lower Standards of Infusion Care
• Op-Ed: Rick Pollack, The Hill, “Proposed Medicare cuts jeopardize access to care for patients and communities”
• Infographic: Site-neutral Payment Policies Threaten Access to Hospital-level Care
• Proposals to Reduce Medicare Payments Would Jeopardize Access to Essential Care and Services for Patients
• Infographic: Setting the Record Straight: Private Equity and Health Insurers Acquire More Physicians than Hospitals
• Study: Comparison of Medicare Beneficiary Characteristics Between Hospital Outpatient Departments and Other Ambulatory Care Settings (KNG Health Consulting LLC, on behalf of the AHA)