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Hospitals to Congress: Drop Payment Cap Proposal

John Commins, for HealthLeaders Media, September 14, 2012

"We often think of ambulatory care and the clinics providing primary care. That is certainly true, but in addition, our members have specialty clinics that often act as a medical home for those complex patient populations. For example, most of our members will have a cardiovascular clinic, a diabetic clinic, a pain clinic, cancer clinics, and the patients that we serve really don't have any other source of care to manage those really complex medical conditions."

Feldpush says capping outpatient reimbursements doesn't meld with the integrated care model that the federal government is advocating.

"As we think of moving to integrated care, providing better care in the ambulatory setting to keep people out of the hospital, reaching out to folks who don't have good access now, this proposal seems to fly in the face of that," she says.

"This proposal contradicts the agreed upon goals we are all working for, integrated care and providing care in the least-resources-intensive setting for the benefit of patients."


John Commins is a senior editor with HealthLeaders Media.

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1 comments on "Hospitals to Congress: Drop Payment Cap Proposal"


Lawrence Lewis, CEO, PMHD (9/19/2012 at 11:23 AM)
The proposed payment cap that would reduce hospital payments to the difference between hospital based ER visits and physician office patient visits, does not consider the burden that is placed on hospitals to see EVERY patient that arrives on campus seeking maedical care. It does not take into consideration the cost of maintaining a service 24X7 that is prepared to see patients of any condition and unknown medical history from a pulled chest muscle resulting from a cough or sneeze, to a blockage that could ultimately end up with open heart sugery. They do not consider the patients that walk in with a headache due to lack of sleep to a pain symptomatic of a brain aneurism. Proposed signficant changes to compensation structures should be researched thoroughly and based on the cost of providing the services that are being required of a hospital emergency rooms. This is why it's important for legislators to develop working relationships with the hospital associations that engage industry leaders in collaborating to develop sound proposals.