Leading Publication Discusses OIG Recommendations on HOPD Medicare Payments

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Ambulatory surgery centers (ASCs) have been a major focus of our discussions, publications, and presentations in 2014 here at Somnia Anesthesia. Concurrently, they have been in the spotlight of the healthcare world as well. With many changes in regulatory and pay-for-performance programs from the Centers for Medicaid and Medicare Services (CMS) and other oversight agencies, outpatient facilities have faced immense pressure like never before.

However, the pressure may shift to hospital outpatient departments (HOPDs) with a recent recommendation from the Office of the Inspector General (OIG). According to www.outpatientsurgery.net, the OIG is suggesting that CMS should reduce HOPD reimbursement payments down to ASC levels, which is already staggering low in comparison to hospitals. The OIG argues that this could save Medicare $15 billion between 2012 and 2017.

According to the article, this change in payments for HOPDs would require changes in legislation; therefore the OIG has also made suggestions for those changes as well. However, CMS does not yet agree with the OIG and it doesn’t seem that any of these recommendations are going to come to fruition any time in the immediate future.

However, we at Somnia recommend to all hospital owner and management that they keep close watch on recommendations and prospective policies such as these. CMS will always find ways to cut their costs. If a policy like this did take effect, it would have a significant effect on revenue for hospitals nationwide. If hospitals don’t plan and strategize accordingly, results could be catastrophic for some hospitals and their most important shareholders: their patients.

Stay ahead of prospective policies such as these and ensure success in the future for your hospital.

If you have any concerns over policies such as these, please let us know by emailing us at [email protected].

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