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What is Fair Payment for Outpatient Care?

Rene Letourneau, for HealthLeaders Media, March 25, 2013

During the meeting, the panel heard a variety of presentations from technology vendors and providers. "The topics ranged from the classification of proton therapy—a very high-end, narrow service—to many services that had much broader applications to much larger populations," Zimmer said. "Most were situations where a technology has evolved that has allowed a change in patient care … or a change in the standards of care."

"In one case, a technology company wanted to achieve what they felt was appropriate and fair payment," Zimmer says, adding that another presentation was given by a specialty provider group that believes the current payment methodology for their services is behind the times.

The topics will all be subject to "further evaluation and discussion in future meetings," Zimmer says. The next meeting date has not been set, but will likely take place in the late summer.

Improvements in technology and a more patient-centered approach to care delivery will fuel providers' efforts to keep patients out of the hospital and toward delivering more care in ambulatory settings. And it will remain important for providers to be paid appropriately for their services.

Zimmer is optimistic that the panel will play a significant role in keeping provider payments at fair levels and says he's happy to be part of the process. "I think it's a big challenge, but I am hopeful. The panel will be at the forefront in many ways. I'm excited for this opportunity to provide input into how Medicare evolves its payment policies."

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1 comments on "What is Fair Payment for Outpatient Care?"


Daniel Ross (3/25/2013 at 1:58 PM)
The outpatient hospital, CMS negotiations result additionally impacts the fees being paid by commercial health plan sponsors. Typically, the dollars not paid by the public plans were cost-shifted on to the commercial payors. One wonders how this committee can impact the Medicare cuts imposed by PPACA?