Published 8/7/2018

AAOS Supports CMS Site Neutrality Expansion Rule

Washington, DC—American Association of Orthopaedic Surgeons (AAOS) President David Halsey, MD, today issued the following statement in response to the inclusion of site-neutrality expansion to previously exempt off-campus providers by the Centers for Medicare and Medicaid Services (CMS) in its Calendar Year (CY) 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System newly proposed rule:

“Increasing accessibility to affordable, quality musculoskeletal care is the highest priority for the AAOS—especially as the cost for services and basic patient visits at hospital outpatient facilities continues to rise. Therefore, the Association strongly supports the newly proposed measure to expand site-neutral payments to previously exempted off-campus facilities.”

“While we recognize that payment variation by site is part of CMS’ overall payment system, economic inefficiencies are created when these natural variations become inflated. The variation in the Medicare payment system has resulted in inefficient care, increased consolidation of physician practices into hospital systems, and increased costs to Medicare patients who face higher co-pays for outpatient services compared to services provided in an office setting. Thus, payment variation has an important impact on patient choice.”

“By equalizing payments between physician offices and off-campus provider-based departments (PBD) and helping to reduce the cost disparity, the OPPS rule will save patients an estimated $150 million in lower copayments. More importantly, it will empower patients to make their own health care decisions such as choosing the site of service that is most convenient. These benefits, in addition to an increased service cost transparency, are critical to the patient-centered care we strive to provide. The Association commends CMS for this long-overdue and much needed effort.”

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Department of Health and Human Services, Centers for Medicare & Medicaid Services’ Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program: