Alliance for Site Neutral Payment Reform Applauds Inclusion of Site Neutral

Provision in New Proposed Medicare Rule

New rule would reduce spending for Medicare patients and the federal government by more than
$760 million.

Washington, DC, July 31, 2018 --(PR.com)-- Today the Alliance for Site Neutral Payment Reform
commended the Centers for Medicare & Medicaid Services (CMS) for proposing to expand site neutral
payments for all outpatient clinic visits in its CY19 Medicare Hospital Outpatient Prospective Payment
System and Ambulatory Surgical Center Payment System proposed rule.

The rule, if finalized and implemented, would reduce the payment differences between sites of service,
including hospital outpatient departments (HOPDs) and freestanding community clinics, which have been
absorbed by hospital systems at an alarming rate in recent years. In addition to leveling the playing field
between different sites of service, the proposed rule would empower patients to make more informed
healthcare decisions by making the costs of healthcare, especially out-of-pocket costs, more transparent.

“We welcome the proposed site neutral policy included in the proposed outpatient rule and commend
CMS for recognizing the fundamentally flawed payment systems that allow hospitals to charge drastically
higher prices than community clinics for providing the exact same services,” said Randy Broun, MD,
medical oncologist and president of Oncology Hematology Care. “Because healthcare costs have
emerged as Americans' primary financial concern, and the cost of care has been steadily rising -
especially for Medicare patients with cancer - it is absolutely essential that CMS close the regulatory
loopholes that drive up the costs of care for Medicare patients.”

CMS estimates that expanding site neutral payments will result in significant savings for both patients
and the federal government. By reducing payment differences between sites, Medicare is projected to
save $610 million as a result of the new rule, while patients will save $150 million in lower copays in
2019 alone.

Under current rules, both Medicare and patients pay more for services delivered in HOPDs than in
freestanding physician offices: chemotherapy: $281 vs. $136; cardiac imaging: $2,078 vs. $655;
colonoscopy: $1,383 vs. $625; even a basic E/M visit costs $51 more when performed in a HOPD. As a
result, Medicare patients have spent $411 million more in out-of-pocket costs over a three-year period
when receiving certain services in an HOPD instead of the physician's office.

Payment disparity is also driving the rapid acquisition of community practices by hospitals - a process
called vertical integration. Between July 2014 and January 2015 alone more than 13,000 physician offices
were converted into HOPDs so that hospitals could take advantage of higher reimbursement rates.

“Payment disparities across different sites of service create unjustified financial stress on patients and the
Medicare program,” said Michael Munger, MD, president of the American Academy of Family
Physicians. “Not only have Medicare beneficiaries been forced to pay more at HOPDs, but vertical

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integration has caused many community clinics to close their doors, ultimately undercutting patients' right
to choose where they receive their care. The Alliance for Site Neutral Reform looks forward to working
with CMS to ensure this provision is finalized in the final rule so the cost of care is the same regardless of
the setting patients choose.”

About the Alliance for Site Neutral Payment Reform

The Alliance for Site Neutral Payment Reform is a coalition of patient advocates, providers, payers and
employers who support payment parity across site of service in order to decrease Medicare and
commercial spending, ensure patients receive the right care in the right setting, lower taxpayer and
beneficiary costs and increase patient access. Our growing membership represents healthcare providers,
patient and consumer groups, insurers and others who believe patients - and the healthcare system -
would be better served by policies that are fiscally wise and preserve and enhance care options.

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Contact Information:
Alliance For Site Neutral Payment Reform
Sarah Rhoades
703-548-0019
Contact via Email
http://www.siteneutral.org/

Online Version of Press Release:

You can read the online version of this press release at: https://www.pr.com/press-release/760922

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