January 3, 2024
ARC has released a new brief evaluating several proposals to expand site neutrality and addressing implications of these proposals in rural and underserved areas. Summary findings are:
- Only 19% of Medicare off-campus hospital outpatient department (HOPD) spending is subject to existing outpatient payment system site neutrality policies.
- Medicare and beneficiaries typically pay two to four times more for a service in an off-campus HOPD than if they had received the identical service in an independent physician office.
- We estimate that expanding site neutrality policies to all off-campus HOPDs would save Medicare and beneficiaries $32 billion over ten years.
Off-campus HOPDs are less common in rurally based hospitals, and site neutrality proposals do not impact facilities specifically targeting underserved populations such as critical access hospitals.