Establishing site-neutral payments for outpatient services is a hot issue in Capitol Hill right now. Advocates say that such policy would lower healthcare costs, saving both patients and taxpayers money. Opponents say that it would put hospitals’ financial security at risk and jeopardize access to care.
CMS finalized updates to its physician fee schedule for 2024, as well as finalized the rule for next year’s Outpatient Prospective Payment System (OPPS). Provider groups are displeased with the updated rules, arguing that both physicians and provider organizations need more monetary relief than what the agency is offering.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
CMS recently revealed its proposals to raise reimbursement rates for hospital outpatient departments and cut payments for physicians. Next year, the agency is planning to decrease physicians’ pay by 1.25% and increase outpatient payment rates by 2.8%. Provider groups are unhappy with the news — AMA President Dr. Jesse Ehrenfeld said the new physician fee schedule will be “almost biblical in its impact.”
Behavioral health, primary care and outpatient visits accounted for more than 97% of telehealth claims received by Blue Cross NC over the last two years, according to newly released data from the payer. In response, the new Blue Cross NC telehealth policy will continue covering these services. But it will not cover telehealth for areas that were found less effective when provided virtually, such as laboratory testing and radiology.
Though telehealth use has dropped since hitting its peak last April, it has stabilized at a much higher level than before the pandemic, says a new report. But not all specialties utilize telehealth equally, with uptake especially high in psychiatry and substance use disorder treatment.
The evolution of healthcare away from traditional hospital campuses is gaining momentum as new technology has become a key driver in the shift to outpatient care.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.