CMS' 3.8% pay bump for hospital outpatient services is 'insufficient' given cost pressures, AHA says

CMS will increase hospital outpatient payment rates by 3.8 percent in 2023, but the American Hospital Association said the adjustment is "insufficient given the extraordinary cost pressures" from labor, supplies, equipment, drugs and other expenses.

In its Outpatient Prospective Payment System final rule, released Nov. 1, CMS will increase both hospital and ASC payment rates by 3.8 percent for those that meet applicable quality reporting requirements. 

For hospitals that do not publicly report quality data, the agency will continue to impose the statutory 2 percentage point additional reduction in payment, resulting in a 1.8 percent OPPS update. CMS estimates that total payments to hospitals will increase by about $3 billion in 2023 compared to 2022.

The AHA welcomed CMS' decision to finalize a general payment rate of average sale price plus 6 percent for drugs and biologicals acquired through the 340B drug pricing program and the establishment of a new Medicare provider — rural emergency hospitals — to address support rural and critical access hospitals. 

But the AHA reiterated that hospitals need more support to address financial challenges, with many hospitals on course for their worst financial year in decades.

"Hospitals are still dealing with a wide range of challenges in providing care, which is why the AHA is urging Congress for additional support by the end of the year," Stacey Hughes, executive vice president of the AHA, said in a Nov. 1 news release. 

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