Ambulatory Spending

Healthcare Spending to Pick Up Pace, Reaching $7.2T by 2031

June 14, 2023 - National healthcare spending slowed during the COVID-19 public health emergency (PHE) as the entire industry experienced severe disruptions to standard care. Now that the PHE has ended, healthcare spending growth is expected to pick back up to reach $7.2 trillion by 2031, according to new estimates from the Office of the Actuary (OACT). Published...

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National Healthcare Spending Grows 2.7% as COVID-19 Relief Runs Dry

by Jacqueline LaPointe

National healthcare spending is slowing down in the US compared to a significant 10.3 percent increase in 2020. However, healthcare costs remain high as US health expenditures reach $4.3...

Before COVID-19, Healthcare Spending Increased by 4.6%

by Jacqueline LaPointe

National healthcare spending continued to grow right before the COVID-19 pandemic hit, increasing by 4.6 percent in 2019 to a total of $3.8 trillion, the American Medical Association (AMA)...

National Healthcare Spending Increased to $3.6T in 2018

by Jacqueline LaPointe

National healthcare spending in 2018 grew at a rate of 4.6 percent to $3.6 trillion, which translated to about $11,172 per person, the Office of the Actuary at CMS recently reported. The growth rate...

OIG Suggests Lowering Medicare Reimbursement for More Part B Drugs

by Jacqueline LaPointe

CMS could have saved an additional $2.9 million in 2017 if the agency lowered Medicare reimbursement for more Part B drugs through price substitution, the HHS Office of the Inspector General (OIG)...

HOPDs Treat Sicker, Poorer Medicare Patients Compared to ASCs

by Jacqueline LaPointe

Hospital outpatient department (HOPD) clinics treat poorer and sicker Medicare patients compared to those treated in ambulatory surgical centers (ASCs), according to a recent study from the American...

Care Volume, Prices Are Increasing in the Outpatient Setting

by Jacqueline LaPointe

Healthcare services performed in the outpatient setting versus the physician office increased from 11.1 percent to 12.9 percent from 2009 to 2017, and the trend is having a significant impact on...

More Outpatient Site-Neutral Payments to Cut Costs, Coalition Says

by Jacqueline LaPointe

Extending and establishing site-neutral payments for outpatient services is the key to lowering healthcare costs, a coalition of patient advocates, providers, payers, and employers recently told...

More Hospitals Sue HHS Over Outpatient Site-Neutral Payments

by Jacqueline LaPointe

Thirty-eight hospitals filed a lawsuit against HHS over a $380 million reduction in Medicare reimbursement to hospitals under a new outpatient site-neutral payment policy. The lawsuit alleges that HHS...

Average Healthcare Costs for Outpatient Visit Nears $500

by Jacqueline LaPointe

Healthcare spending growth may be slowing, but healthcare costs in the US still significantly outpace those of other nations, a new analysis shows. As part of a larger study to determine the funding...

Hospital Groups Decry Proposed Outpatient Reimbursement Cuts

by Jacqueline LaPointe

Hospitals groups are voicing their concerns with potential site-neutral payments and other outpatient reimbursement reductions proposed in a new rule from CMS. CMS released its proposed CY 2019...

Medical Prices Grew 28% for Hospital E&M Services Since 2012

by Jacqueline LaPointe

Medical prices for hospital evaluation and management (E&M) services rose 28 percent and allowed amounts increased 26 percent between May 2012 and 2017, the most recent FH Medical Price Index from...

CMS Clarifies Site-Neutral Medicare Reimbursement Exceptions

by Jacqueline LaPointe

With the site-neutral Medicare reimbursement policy taking effect on Jan. 1, CMS recently released guidance on what hospital departments qualify for exemption from the rule. The federal agency clarified...

OIG Finds Medicare Payment Problems with Two-Midnight Policy

by Jacqueline LaPointe

Hospitals may face more Medicare reimbursement audits on inpatient and outpatient claims after the Office of the Inspector General (OIG) recently found several vulnerabilities associated with the...

AHA Asks CMS to Increase Site-Neutral Medicare Reimbursement

by Jacqueline LaPointe

The American Hospital Association (AHA) recently advised CMS to increase Medicare reimbursement rates to off-campus provider-based outpatient departments that will be paid under site-neutral payment rules...

CMS Updates Site-Neutral Payment Reform Implementation Rule

by Jacqueline LaPointe

In a recent ruling on the outpatient prospective payment system, CMS finalized several changes to the site-neutral payment reform policy under which most provider-based hospital outpatient departments...

AHA: Delay Site-Neutral Rule to Address Medicare Fraud Risks

by Jacqueline LaPointe

The American Hospital Association (AHA) has asked CMS to delay the implementation of proposed site-neutral payments for another year because the payment reform rule could increase a hospital’s...

Ambulatory Surgery Centers Help Reduce Healthcare Costs

by Jacqueline LaPointe

With a push for more healthcare transparency, more beneficiaries are now equipped to reduce healthcare costs by selecting the cheapest option for medical services. However, some providers may not be as...

Hospital Mergers and Acquisitions Causes Cancer Costs to Rise

by Catherine Sampson

Although hospital mergers and acquisitions typically generate revenue for the healthcare system, they can also lead to increased medical costs –especially among commercially insured patients. In a...

How to Boost Ambulatory Revenue Cycle Management Performance

by Jacqueline DiChiara

Ambulatory revenue cycle management is driven by a variety of factors, such as the market growth of Electronic Health Records (EHRs), the meaningful use program, and technological trends. Operating as...

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