Outpatient Care Providers

Hospital Outpatient Departments Preserve Care Access for Rural Patients

February 1, 2024 - Rural populations and other vulnerable patients disproportionately rely on hospitals and their outpatient departments for care, according to a report from the American Hospital Association (AHA). Rural communities often face gaps in care access. These areas typically have fewer people and lower healthcare utilization, making it financially...

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Hospital Outpatient Revenue Growth Contributes to Positive Margins

by Victoria Bailey

Hospital outpatient revenue is growing as patients seek healthcare services in less expensive settings, a performance trends report from Strata Decision Technology and Syntellis Performance Solutions...

CMS Boosts End-Stage Renal Disease Medicare Rates by 2.1%

by Jacqueline LaPointe

CMS recently released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule for 2024, which includes a 2.1 percent Medicare rate hike for renal dialysis services furnished to...

Healthcare Services Cost More at Hospital Outpatient Departments

by Victoria Bailey

Costs for common medical procedures were up to 58 percent higher when they were performed in a hospital outpatient department compared to a doctor’s office, an analysis from the Blue Cross Blue...

AHA: Site-Neutral Payment Policies Hurt Hospitals

by Jacqueline LaPointe

As healthcare prices are put under the microscope, the American Hospital Association (AHA) is criticizing a cost-cutting method to reduce prices for outpatient services. The hospital group’s...

OPPS Rule to Update Outpatient Payments, Hospital Price Transparency

by Jacqueline LaPointe

CMS proposes in the Outpatient Prospective Payment (OPPS) rule to increase Medicare outpatient payments by 2.8 percent next year while bolstering hospital price transparency enforcement. The OPPS rule...

CMS to Resolve 340B Payment Mixup With $9B Lump-Sum Fix

by Jacqueline LaPointe

CMS has proposed to pay $9 billion to hospitals impacted by payment cuts to the 340B Drug Pricing Program between 2018 and 2022. The proposal is CMS’ remedy to cutting 340B payments from the...

Hospital Finances Stabilized as Revenues Grew, Expenses Fell

by Victoria Bailey

Hospital finances stabilized in May as operating margins remained positive, revenues increased, and expenses fell, a report from Kaufman Hall shared. The latest report reflects hospital performances...

Site-Neutral Payments Could Threaten Access to Care, Study Suggests

by Jacqueline LaPointe

A new study released by the American Hospital Association (AHA) suggests that site-neutral payments could threaten access to care for some of the most vulnerable patients. Site-neutral payments...

4 Common Surgeries Shifted to Outpatient During COVID-19

by Jacqueline LaPointe

The COVID-19 pandemic prompted greater uptake of outpatient surgery for four commonly scheduled general surgery operations, according to a new study in JAMA Network Open. Hospitals in the American...

Providers are Increasingly Billing Outpatient Visits at Higher Levels

by Victoria Bailey

Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill...

Outpatient Sector Saw the Most Private Equity Investments in 2022

by Victoria Bailey

Over 400 private equity firms invested in the healthcare sector in 2022, with outpatient care seeing the most deal activity, according to a report from the Private Equity Stakeholder Project...

Hospital Execs Expect Greater Shift to Outpatient Care

by Jacqueline LaPointe

Hospital and health system executives are expecting large increases in outpatient volume this year, according to a recent analysis from the Guidehouse Center for Health Insights. The Center for Health...

UPMC Shifts Site To An Outpatient Emergency Department

by Jacqueline LaPointe

UPMC is converting a small hospital in rural Clinton County, Pennsylvania, to an outpatient emergency department (ED) under the state’s new Innovative Hospital Models project. Innovative Hospital...

Elective Surgeries Shifted from Inpatient to Outpatient Settings

by Victoria Bailey

Inpatient surgery utilization levels declined between 2019 and 2021, while utilization rates in outpatient settings increased, according to data from Cedar Gate Technologies. The findings reflect...

OPPS, ASC Final Rule Boosts Medicare Reimbursement by 3.8%

by Victoria Bailey

UPDATED 11/02/2022 at 10:00 AM EST: The Calendar Year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule from CMS has...

OIG: CMS System Edits Reduced Medicare Overpayments to Hospitals

by Victoria Bailey

CMS system edits helped reduce Medicare overpayments to acute care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, a report from the Office of...

AHA Asks Federal Court to Immediately Stop 340B Payment Cuts

by Jacqueline LaPointe

The American Hospital Association (AHA) has asked the US District Court for the District of Columbia to order HHS to immediately halt underpayments to hospitals participating in the 340B Drug Pricing...

CMS Proposes 2.7% Increase in CY23 OPPS, ASC Reimbursement Rates

by Victoria Bailey

CMS has released its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, which includes a 2.7 percent...

New Internists Are Choosing Hospitals Over Outpatient Settings

by Victoria Bailey

Newly certified internists commonly choose to practice medicine in hospitals rather than outpatient settings, suggesting that the outpatient primary care physician shortage will escalate, according to...

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