In a piece with Real Clear Health, Mathias P. Bostrom, MD, Associate Surgeon-in-Chief and Director of Quality and Safety at HSS, discusses the importance of ensuring Medicare's cost-cutting reforms, like site-neutral payments, don't compromise access to specialized care. 

Here's a healthcare puzzle. When a doctor administers chemotherapy in their office, Medicare pays one rate. When the same doctor performs the same procedure in a hospital's outpatient facility down the street, Medicare often pays more.

This disparity is at the heart of a push among some lawmakers for "site-neutral payments," which would broadly require Medicare to pay the same rate for the same service regardless of where it's performed. A bipartisan framework from Sen. Bill Cassidy, R-La., and Sen. Maggie Hassan, D-N.H., estimates that site-neutral payments could save Medicare over $100 billion in the next decade.

The argument for site-neutral payments makes sense. The current policy encourages hospitals to buy up independent physician practices just to charge Medicare higher rates. And it requires Medicare beneficiaries to pay more out of pocket for a given service based solely on where it's delivered.

But in the rush to fix this genuine problem, policymakers risk creating another one. Site-neutral payment reforms, as currently proposed, could jeopardize the ability of super-specialty hospitals and their outpatient facilities to deliver the high-quality care they're renowned for.

These aren't your typical community hospitals that handle everything from broken arms to pneumonia. Super-specialty hospitals focus on specific types of care -- think cancer treatment at Memorial Sloan Kettering, joint replacements at the Hospital for Special Surgery, or pediatric care at the likes of Children's Hospital Colorado.

Super-specialty hospitals' outpatient facilities aren't converted doctor's offices with a hospital logo plastered on the door. They're purpose-built extensions of the main hospital, offering the same sophisticated care but in more accessible locations.

The difference matters for three key reasons.

Read the full article at realclearhealth.com.