CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services

Cheryl Clark, for HealthLeaders Media , December 2, 2013

"These changes are essential if we're going to create a healthcare system that delivers better care at lower cost," Blum said in a news release. "The final OPPS/ASC rule gives hospitals a stake in managing their resources to generate better coordinated and ultimately, more affordable outpatient care."

The American Hospital Association executive vice president Rick Pollack said in a statement that the AHA "is extremely disappointed" with some of these new provisions, specifically those that bundle clinic services, saying that they will "hurt hospitals' ability to provide outpatient care."

He added that he doesn't think CMS used correct information in coming to its decision to collapse the five outpatient codes.

"While we are pleased that CMS has decided not to collapse its codes for emergency room visits, we are very concerned that CMS is moving forward with consolidating all outpatient clinic visit codes into a single code representing a single level of payment," he said. "Hospitals that provide care for large numbers of complex patients will receive payment well below the cost of treating these patients.

"Hospitals will have neither the time nor the data to understand how these changes will affect their ability to provide patient services. In adopting these proposals, CMS has put hospitals in the difficult position of having only 35 days to implement significant changes in Medicare's policies, procedures, and payment formulas."

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