Site-neutral payments likely to move forward, experts believe

As the Centers for Medicare & Medicaid Services and the Medicare Payment Advisory Commission evaluate site-neutral payments, a new brief from Health Affairs and the Robert Wood Johnson Foundation explores the debate and proposals.

MedPAC is looking at proposals that would explore reducing payment differences between inpatient rehabilitation facilities and skilled nursing facilities, an idea that has been met with support from the American Health Care Association but opposition from the IRF side.

While site-neutral payments are not definite, “CMS and MedPAC have indicated continued interest in identifying and addressing situations where differences in payment are not considered appropriate,” the brief states.

MedPAC, which is especially concerned about the shift to procedures done in hospital outpatient centers rather than a physician’s office, seeks to have the same payment for the same service across sites of care, the brief noted.

“The issue of determining which of the different estimates of the cost of providing the same service is most appropriate raises the question of whether and how Medicare payments should be revised to reflect the value, not just the cost, of the service,” the brief states.