MedPAC recommends slashing payments for some standalone EDs by 30%

The Medicare Payment Advisory Commission on April 5 approved reducing payments for a number of standalone emergency departments across the country, according to an American Hospital Association report.

MedPAC proposed the reduction in its March report to Congress. The commission specifically recommended a 30 percent payment rate reduction for off-campus standalone EDs that are no more than six miles from an on-campus hospital ED, according to the AHA.

The AHA came out against the recommendation in a March 29 letter, saying reducing the ED payment rates "is unfounded and arbitrary," partially because the recommendation is based on data from only Maryland, Texas and Colorado "that are not representative" of the entire U.S. The AHA also stated the recommendation does not include examination of Medicare enrollees, Medicare costs or Medicare payments and contended the proposal "would make the already-record Medicare underpayment of outpatient departments and hospitals even worse." The AHA  cited outpatient Medicare margins it argued were a record-low negative 14.8 percent in 2016, among other data. The organization said overall Medicare margins will reach a new record low of negative 11 percent this year.

According to the AHA, MedPAC has also recommended allowing isolated rural hospitals that are more than 35 miles from another ED to convert to standalone EDs that could receive payment under the outpatient prospective payment system. The AHA has supported this recommendation and urged MedPAC to also include EDs in vulnerable urban areas.

Read more about recent MedPAC recommendations here.


More articles on healthcare finance:
UCLA Health to establish health sciences learning center with $20M gift
7 latest hospital credit downgrades
10 hospitals seeking RCM talent

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars