New Study Shows Rural Hospitals Benefit Most from Medicare Payment Changes

February 15, 2018

Eighty Five Percent of Hospitals Will See Net Payment Increases from Recent Medicare Part B Outpatient Payment Changes

Ted Okon, Executive Director, Community Oncology Alliance

(Washington D.C., Thursday, February 15, 2018) – Eighty five percent of hospitals will see net payment increases from recent Medicare Part B outpatient payment changes, with rural hospitals seeing much greater overall payment increases for 2018 than urban hospitals. These findings are included in new research released by Avalere Health, which was commissioned by the Community Oncology Alliance (COA).

The study “2018 OPPS Medicare Part B Payment Impact Analysis” is the first to investigate the net financial impact of a restructuring of payments for Part B drugs to correct the unintended consequence of some 340B hospitals profiting from the program. The study dispels misinformation that the new payment formula will result in hospitals seeing a drastic cut in reimbursement.

Ted Okon, executive director of the Community Oncology Alliance, explains.

SOUNDBITE #1:

CONTRARY TO THE HYPE AND MISINFORMATION WE HAVE SEEN IN RECENT MONTHS, THIS STUDY CLEARLY SHOWS THAT THE VAST MAJORITY OF AMERICA’S HOSPITALS, AND IN PARTICULAR RURAL HOSPITALS, ARE BENEFITTING FROM THE RECENT THREE FORTY B DRUG PRICING PROGRAM AND MEDICARE PAYMENT CHANGES.  IN LIGHT OF THESE FINDINGS AND THE CAMPAIGN OF DECEPTION BEING WAGED BY SOME IN D-C, CONGRESS MUST ACT NOW TO INTRODUCE TRANSPARENCY AND ACCOUNTABILITY TO THIS PROGRAM SO THAT LIGHT IS SHINED ON THE BLACK HOLE OF HOW THIS PROGRAM REALLY OPERATES IN HOSPITALS.

SOUNDBITE #2:

FOR FAR TOO LONG, LARGE CORPORATE HOSPITALS HAVE BEEN ABUSING AND ENRICHING THEMSELVES OFF OF THESE PROGRAMS AND IT HAS COME AT THE EXPENSE OF TAXPAYERS AND PATIENTS, INCLUDING THE VERY VULNERABLE PATIENTS THAT THE PROGRAM IS INTENDED TO HELP.  THE CENTERS FOR MEDICARE AND MEDICAID SERVICES SHOULD BE COMMENDED FOR TAKING THIS BOLD FIRST STEP AND WISELY ADJUSTING THE COURSE OF THE RUNAWAY THREE FORTY B DRUG PRICING PROGRAM SO THAT RURAL HOSPITALS GET THE SUPPORT THEY NEED AND PATIENTS BENEFIT.

A full copy of the study and methodology are available at communityoncology.org.

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