Alex Azar and Kathleen Sebelius, who served as secretaries for the Department of Health and Human Services under former presidents Donald Trump and Barack Obama, respectively, advocated for a bipartisan adoption of site-neutral healthcare payments in an opinion article published in Stat in April.
Site neutrality would equalize payments between healthcare facilities that are owned by hospitals or corporate health systems and those that are independent. Currently, hospitals currently receive higher reimbursement rates than ASCs or independent physicians, despite no documented improvement in quality of care.
Mr. Azar and Ms. Sebelius argue that the current payment system drives up costs for patients and discourages competition. According to data from a June 2022 report by the Medicare Payment Advisory Committee, cancer patients receiving care in an HOPD paid more than 141% more than if the exact same care took place in an ASC or independent facility.
The authors cite attempts by both the Obama and Trump administrations to sign site neutrality into law, such as the Bipartisan Budget Act of 2015 under Mr. Obama and the Trump administration's attempt to expand site neutrality to previously exempted facilities.
Last June, MedPAC recommended that lawmakers enact site-neutral payments for certain low-complexity medical services such as office visits, X-rays, minor procedures and drug injections. These changes could result in billions for patients and taxpayers, while "reducing perverse incentives for consolidation," the authors write.
Site neutrality could alleviate the mounting pressure that ASCs and independent physicians face in a healthcare market that is rapidly consolidating, and give them a more equal opportunity for growth.