Hospitals remain at risk as Congress weighs doc fix, changes to sequester

AHA News

With Congress still eyeing hospitals for possible budget savings, the AHA last week took aim at proposals circulating on Capitol Hill to adopt “site-neutral” payments for hospital outpatient department (HOPD) services. In a Nov.14 “Legislative Action Alert” to the field, the AHA said HOPD cuts remain a “serious threat,” and urged hospital leaders to “redouble your efforts” to stop them.

The Medicare Payment Advisory Commission and other policymakers have recommended Congress reimburse hospitals at the lower rates paid when these types of services are provided in a physician’s office or an ambulatory surgical center (ASC). The AHA and hospital leaders say cutting HOPD payments threatens patients’ access to care.

The recent message to the field on site-neutral payment proposals is part of the AHA’s efforts to maintain a steady drumbeat of opposition to any attempt on Capitol Hill to cut hospital funding as a way to roll back the sequester’s sharp automatic cuts to agency spending or to help pay for a physician payment fix (see related story on page 1).

In making the case against site-neutral payments, the AHA points out that hospitals play a unique standby role as providers of around-the-clock emergency, safety net and disaster response care. HOPDs have higher costs than physician offices due to their standby and teaching roles, sicker patient population and greater
regulatory requirements.

Hospital leaders get an opportunity to make their case against cuts to HOPD and other hospital programs when they come to Washington, DC, for the AHA’s next Advocacy Day meeting on Dec. 3.

The meeting will take place as a congressional conference committee continues its efforts to meet a Dec. 13 deadline for establishing a budget resolution for the fiscal year that began Oct. 1. The conferees are tasked with resolving differences in the budget proposals that cleared the House and Senate earlier this year.

The House budget resolution, H. Con. Res. 25, would cut Medicaid spending by $810 billion over 10 years and blockgrant the program, turn Medicare
into a premium support system, and repeal large portions of the “Patient Protection and Affordable Care Act.” The Senate budget resolution, S. Con. Res. 8, would reduce Medicare spending by $275 billion and Medicaid spending by $10 billion, and eliminate the sequestration cuts.

There are no repercussions if negotiators fail to reach an agreement by the Dec. 13 deadline. Still, conference leaders hope to agree, at the very least, on a plan to replace the sequester’s cuts with more considered reductions to other parts of the federal budget. That would permit Congress to set a funding level for federal agencies for this fiscal year and keep the government open past a Jan.

15 deadline. During their Dec. 3 visits to Capitol Hill, many hospital leaders also plan to urge legislators and their staff to reject cuts to hospitals’ graduate medical education (GME) funding, which is another budget-saving option circulating on the Hill. To help convey their concerns about GME cuts to lawmakers, hospital leaders recently received an AHA “infographic” on teaching hospitals.

The infographic describes teaching hospitals as “vital for tomorrow’s health care.” It carries this message: “Increase Medicare-funded residency positions to preserve the medical landscape of tomorrow – Don’t cut funding for training future caregivers” (Click here to see the infographic.

Topic: Advocacy and Public Policy

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