With Site-Neutral Payment Efforts Stalled, Debate Over Policy’s Merits Continue

June 28

Politicians from both parties have been pushing for site-neutral payment reforms, a concept that says payers should reimburse the same amount for outpatient services regardless of whether the service is performed in a hospital, ambulatory surgical center or physician’s office. But getting such a policy passed by Congress has proven elusive. And as Larry Levitt, KFF’s executive vice president for health policy, said during a June 17 KFF webinar: “It’s anybody’s guess what Congress might do in this divisive and chaotic political environment.”

Advocates for site neutrality came close to notching an incremental win last December when the House of Representatives passed the Lower Costs, More Transparency Act, which included a provision for Medicare site-neutral payments applying to drugs administered in an outpatient setting. However, the legislation has since stalled.

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Tim Casey

Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.