May 2, 2023
WASHINGTON, DC — Today, the CardioVascular Coalition (CVC) is responding to the Washington Post Editorial Board’s opinion regarding concerns about hospitals buying independent doctors’ offices and the effect this dynamic is having on Medicare’s fiscal sustainability
The Editorial Board’s suggested solution to these concerns is implementing a policy that would bring down hospital rates to levels comparable to those of independent office-based specialists. Unfortunately, as a result of ongoing cuts to office-based specialists in the Medicare Physician Fee Schedule (MPFS), this particular site-neutral policy would lower hospital Medicare reimbursement rates to levels that already are unsustainable for office-based specialists. Such an approach would not protect independent doctors’ offices.
“Medicare pays more for services performed on an outpatient basis at hospitals than it does for the same services done at physicians’ offices or ambulatory surgical centers. This makes no sense and creates an incentive for hospitals to buy up independent doctors’ offices that they then relabel as hospital facilities. Eliminating this discrepancy could save $141 billion over 10 years.” (Washington Post, 3/23/2023)
The solution the Post provides appears to be a policy which would lower hospital rates to already unsustainable independent doctors’ office rates. CVC continues to emphasize that as Congress continues to work on fundamental Medicare reform, it needs to reassess how cuts, like those included in the MPFS for 2021 – 2023, are creating a ripple effect through the entire healthcare system by further limiting patient options for care. If Congress and the Centers for Medicare & Medicaid Services (CMS) hope to stop the acquisition of independent doctors’ offices by hospitals, the most direct approach is simply to stop cuts to office-based specialists under the MPFS that are ongoing through 2025. This approach has bipartisan support and would better protect office-based specialists from further closures and acquisition by hospitals.
Jeffrey G. Carr, MD, an Interventional Cardiologist, Endovascular Specialist, and CVC Board member, stated:
“Office-based specialists play an essential role in our healthcare system, especially for patients with Peripheral Artery Disease (PAD). Without their care, patients are left with fewer options and, unfortunately, less specialized care that too often leads to avoidable, but grave consequences, like amputation. I am glad The Post is bringing attention to the deeply troubling consolidation trend, but the solution The Post provides appears to be a policy that is neither good for independent doctors’ offices nor hospitals. While the MPFS clearly needs reform, in the near-term, Congress just needs to stop cutting reimbursement for office-based specialty care; that’s it.”