AAFP Agrees With The CMS On Equitable Payment Rules
This one is going to be really interesting. The OPPS or 2019 hospital outpatient prospective payment system (OPPS) would reduce payment differences between sites of service. The AAFP feels it would save money for Medicare and patients and improve payment for independent practices. Maybe.
The AAFP encouraged CMS to “create incentives for services to be performed in the most cost-effective location, such as a physician’s office,” and called the differences between inpatient, outpatient and other sites of service an “artificial distinction” that springs from the “equally artificial distinction” between Medicare parts A and B.
You can read the article via the link above. If the CMS figures a way to not pay hospitals more in their physician outpatient practices (I believe this is the whole “facility fee” scam) then will hospitals unass all the physician offices they own? Will doctors be free again? Will they flounder billing insurance companies again or go to the light of DPC?
One wonders. What do you think?
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More lip-flapping from the AAFP, which is totally in bed with hospital corporations.
If they ever tell CMS that unless a proposed policy contains payment equality regulations, they will very loudly and publicly oppose it (full page ads, TV spots, etc.) – well, then I might believe them
If CMS changes even just the E/M payment structure, hospital-based employee primary care will be faced with a significant pay cut. They won’t try to off-load the practices: they’ll just plead poverty, cut salaries, and bet the doctors won’t leave.
If I read the CMS OPPS proposed regs
correctly, the site neutral payment would only apply to E&M codes. If this is true, then I don’t see much impact as far as hospitals shedding physician practices. If the regs do address procedure-based fees/professional fees, then there will be massive offloading of physician practices. I hope for the latter. This would allow for more physicians to start direct pay practices. Both primary care and specialists.
Hospitals want to own primary care to lock referrals for all their services in-network. The fee differential is just icing on that cake.