Editorial Fails to Reflect Significant Differences Between Hospitals & Other Sites of Care

The New York Times editorial on proposed Medicare cuts to off-campus hospital outpatient departments (March 26) fails to reflect the significant differences between hospitals, independent physician offices and other sites of care. These proposed cuts by the administration could threaten access to care for patients in rural and vulnerable communities where hospital-connected care is often the only option available.

Hospitals and hospital systems provide 24/7 access to care for all patients, regardless of their ability to pay, unlike others who provide 9 to 5 care for those with insurance. Our doors are open during natural disasters and in tragic episodes of mass violence. The many life-saving roles that hospitals fulfill are not explicitly funded, but instead, are built into a hospital’s overall cost structure.

As the editorial rightly notes, we are far more likely to treat poorer and sicker patients and have to adhere to much higher and stricter regulatory standards. Payment proposals that attempt to treat hospital outpatient departments the same as independent physician offices and other sites of care ignore the very different level of care provided by hospitals and the needs of the patients cared for in that setting.

Hospitals already incur negative margins treating Medicare patients. In Fiscal Year 2016, Medicare margins for outpatient services were a record low of negative 14.8 percent, and overall, Medicare margins were a record low of negative 9.6 percent.

The fact is that implementing these cuts would be yet another blow for hospitals, health systems and the communities they serve, making it even more difficult to find the resources to meet the ever-changing demands of caring for our patients.  

Rick Pollack is AHA's President and CEO.