Hospitals are open 24/7 and have to respond to a wide array of problems, so Medicare reimburses them at higher rates than doctor offices. Makes sense.
But wealthy hospitals found a loophole: buy neighborhood doc practices, consolidate, and bill at the higher rates. Not cool.
The provider can get 2x or more the reimbursement for routine services simply because the logo on the door changes. This raises costs to 3rd party payors, like employers and government, but also increases costs to patients via their co-pay.
This practice has also led to consolidation of healthcare within cities, often with a couple big systems increasingly controlling all of care delivery.
There is a fix. It's called site neutral. Patients shouldn’t be charged more for the same care simply because of where they receive it.
A bipartisan bill passed the House that made a good first step, ending the overpayments for drug infusion. Now the proposal is in the Senate, where the hospital lobby is going berserk trying to kill it.
We
@Arnold_Ventures are focused on bending the cost curve of healthcare while maintaining quality. Closing this loophole is a great way to do so.