Physician Practice Based Services Less Costly than Hospital Outpatient Department

    By: Melinda Martinson, Esq. on Feb 25, 2016

    A new report by researchers at Avalere Health, released by the Physicians Advocacy Institute (PAI), finds that cardiac imaging services cost three times as much in a hospital outpatient department than in a physician’s office. The “Medicare Payment Differentials Across Outpatient Settings of Care” report compared Medicare payments for three common procedures, echocardiograms, colonoscopies, and evaluation and management services and found that all were less costly in a physician’s office. And, for the first time, this study looked at Medicare payments for entire episodes of care for certain procedures and found them less costly in a physician’s office. PAI has provided the report to the House Energy & Commerce Committee, including ranking member Frank Pallone, Jr. in response to its request for information on implementing a new Medicare policy that would establish “site neutral” payments. Read Health Leaders Media coverage. 

    “This study demonstrates that for many common procedures, Medicare spends much less when patients receive treatment in a physician’s office,” said Kelly Kenney, PAI executive vice president. “At a time when all Americans are concerned about rising healthcare costs, it’s heartening to see opportunities for substantial savings.” …“The study suggests that when care is initiated in hospital-owned facilities, more services follow and these services are also more costly, compared to care that’s provided in a doctor’s office. The payment differential that begins with the initial service extends and is amplified throughout the entire episode.”

    MSNJ is a founding member of the Physician Advocacy Institute. Larry Downs, MSNJ CEO, currently serves on its Physicians Advocacy Liaison Committee. Visit the PAI website to learn more.

    Released: February 25, 2016, 11:39 am
    Keywords: Announcements

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