Medicare's Hospital Markup Is Costing Seniors | Opinion
Summary
Medicare pays much more for the same medical services when they are done in hospital-owned clinics compared to independent doctor offices. The Department of Health and Human Services (HHS) has proposed new rules to pay hospital clinics the same as independent offices for some imaging services, which could save seniors and taxpayers billions.Key Facts
- Medicare pays hospital-owned clinics up to 670% more than independent physician offices for identical services.
- Hospital clinics receive two payments: one to the doctor and a facility fee to the hospital, raising costs.
- This price difference leads hospital systems to buy independent practices and bill higher rates.
- From 2012 to 2024, the number of doctors working in hospital-owned practices increased from 23.4% to 34.5%.
- Medicare beneficiaries pay 20% of outpatient costs, so higher bills mean more out-of-pocket spending for seniors.
- HHS proposed equal payments for hospital-owned clinics and independent offices for certain imaging services like X-rays and MRIs.
- These changes could save $260 million in 2027 and $7.2 billion over 10 years for seniors and taxpayers.
- Expanding these rules further, including for heart imaging services, could save even more money.
Read the Full Article
This is a fact-based summary from The Actual News. Click below to read the complete story directly from the original source.
