Dear AuntMinnie Member,
The U.S. Centers for Medicare and Medicaid Services (CMS) this week expanded on its promise to explore site-neutral payments for some healthcare services -- in this case, clinic visits.
A new proposal would upend long-standing reimbursement policy in which Medicare payments differ based on where a medical service was rendered -- for example, by paying more for a service delivered in a hospital versus at an outpatient center. The differential has long been seen as a way to compensate hospitals for higher costs involved in the overhead of running a large facility.
But the difference has also driven major shifts in healthcare economics as providers move to take advantage of the differential in reimbursement rates. This has led in turn to what CMS calls "perverse incentives" that the agency wants to stamp out.
At present, the CMS proposal only applies to 2019 rates for clinic visits, which are basically physician checkups, and it doesn't appear to apply to radiology. But the move could be an opening salvo of expanding site-neutral payments to other areas.
As any radiology observer knows, outpatient imaging is a major feature of the radiology landscape, and any big change to the reimbursement structure could have massive repercussions. We'll be watching the issue closely, but until we have more details, be sure to get up to speed by clicking here.
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