Dive Brief:
- The Centers for Medicare & Medicaid Services (CMS) issued final payment rates and policy changes for 2017 to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.
- Changes to OPPS and ASC are largely focused on pain management, site-neutral payment rates, and changes to the EHR incentive program.
- OPPS payments will increase by 1.7% and ASC payments by 1.9%, according to CMS estimates.
Dive Insight:
As mentioned in a November 1 statement, changes to OPPS and ASC reflect broader health reform goals adopted by the President and Congress. In the proposed rule published in July, CMS indicated the most recent update to OPPS and ASC was mandated by MACRA and other legislation.
CMS followed through on a proposal to remove patient survey answers as part of pain management care in the Value-Based Purchasing program. Some providers had expressed concern that their consideration could offer a financial incentive to over prescribe medicine, although CMS noted there was no empirical evidence to support this claim.
More and more physicians are employed by hospitals and CMS is trying to slow that trend. Existing payment rates pay more for services provided in hospital outpatient departments than those delivered in a physician’s office. The new rule will level the playing field by paying the same rate for services provided at certain hospital-owned facilities.
With MACRA poised to streamline reporting, the Meaningful Use EHR Incentive program is eliminating clinical decision support and computerized order entry measures. CMS will also introduce a 90-day reporting period for 2016 and 2017 and a hardship exemption for certain providers transitioning to MIPS implemented by MACRA.