Ben Jones Weighs the Implications of Site-Neutral Payments

May 24, 2019

Ben Jones, vice president, Government Relations & Public Policy, McKesson Specialty Health, offers his thoughts on whether site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System will have positive implications for community practices.

Ben Jones, vice president, Government Relations & Public Policy, McKesson Specialty Health, offers his thoughts on whether site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System will have positive implications for community practices.

Transcript

In November, CMS finalized site-neutral payments for outpatient clinic visits under the Outpatient Prospective Payment System. Do you think this change will have positive implications for community practices?

I do. This is one more step toward parity in reimbursement that is going to address this unleveled playing field that currently exists. This is something that often times results in consolidation. The closer we drive to site of service parity, the more we’re going to remove that incentive to consolidate community practices. The 2 things that I will say is that 1: unfortunately, this is something that is tied up in court and it’s very unlikely that Congress or the administration will expand on the policy until the court rules on this actual proposal. 2: unfortunately, what they’ve done by achieving parity in this manner is essentially brining costs down to the lowest common denominator. So, if you think about parity as a disparity in payment as it exists today, hospitals are here and community practices are here. Instead of finding a way to meet in the middle, what they’ve done is just bring everybody down here.

That’s obviously in an effort to show more cost savings from the government’s perspective, but often times that puts a heavier burden on the impacted hospitals, and that’s a conversation that still needs to be had. We don’t want to be in the practice of just taking money from hospitals for money’s sake. We think that the perceived incentives should be removed or we think that this incentive to consolidate should be removed by leveling the playing field, but we don’t want to put hospitals out of business, so let’s have a conversation. Whether that means we meet in the middle or whether that means there’s a separate conversation about overhead costs that hospitals have. Unfortunately, I don’t think any of those conversations will take place until the court actually acts on this proposal.