A proposal to save Medicare nearly $4 billion over a decade is running into stiff opposition.

From hospitals. – and some members of Congress.

Medicare has long paid more for outpatient services provided in hospital-based outpatient departments than it has for the same services delivered in private doctors’ offices.  Critics say this is unfair, that Medicare should pay the same no matter where the service is provided.  Defenders of the practice maintain that hospital-based outpatient departments share higher fixed costs, including for ERs and care for uninsured patients.  They also argue that reducing such Medicare outpatient payments could threaten the financial viability of some physician practices, especially in rural and lower-income urban areas, thereby jeopardizing access to care in such communities.

Disagreement over the issue does not follow party or ideological lines; congressional Democrats and Republicans can be found on both sides of the issue.

Learn more about the battle over site-neutral Medicare outpatient payments and opposition to it from the hospital industry from the KFF Health News article “In Fight Over Medicare Payments, the Hospital Lobby Shows Its Strength.”