URGENT ACTION: Oppose site neutral payments included in federal budget deal

October 27, 2015

TO: WSHA Members and Inside Olympia/ Inside D.C. subscribers

FROM:  Claudia Sanders, SVP Policy Development
Cassie Sauer, SVP Advocacy and Government Affairs
John Flink, federal affairs consultant for WSHA and Oregon Association of Hospitals and Health Systems (OAHHS)

SUBJECT: URGENT ACTION: Oppose site neutral payments included in federal budget deal

Contact your member of Congress today and urge them to oppose site neutral payments in the federal budget deal.

As you no doubt have seen, a federal budget deal was reached and filed late last night. This package is on a fast-track; the House of Representatives could begin voting on it Wednesday – so we have little time to get our message of opposition into the congressional delegation. We urge you to make calls to the congressional delegation today: visit this WSHA page for contact information.

This payment cut is different than the site neutral proposals we have seen in the past. Specifically, under this bill, beginning January 1, 2017, all new hospital-based physician services provided at “off-campus” locations would be paid based solely on the physician fee schedule. Existing hospital-owned practices – as of the date of enactment – would be grandfathered and paid under the current provider-based rules.

This provision creates winners and losers. The losers would be those hospitals still in the process of integrating physician practices into their hospital outpatient departments. It is difficult for us to know how it affects your plans. If it impacts your immediate short term plans, please let us know. That message is especially powerful to our representatives. This payment cut raises all the important issues we have discussed in the past, and need to re-iterate strongly again.

Please contact your members of Congress TODAY to urge them to object to this provision.

Here are points to make in your message:

  • We strongly oppose the site neutral provisions in the budget deal.
  • The health care market as well as policies in the Affordable Care Act are encouraging integration of hospital and physician services. This is a way to better coordinate care and provide care more cost-effectively and efficiently. This provision will make integration less attractive – thus making it more difficult to control health care costs in the future.
  • This provision also would reduce access to services. It is hospital based practices that are willing to continue to see Medicare patients, especially those with high acuity. Provider-based payments have enabled hospitals to offset these higher costs. Loss of these payments could result in hospitals reducing badly-needed services for Medicare beneficiaries.
Please let us know that you have taken action by contacting Claudia Sanders via email or phone at 206/216-2508.


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