Hospital outpatient departments and ambulatory surgical centers will receive 3.1% increases in Medicare reimbursements under a final rule the Centers for Medicare and Medicaid Services published Thursday.
These providers are set for larger pay raises next year than under the proposed rule CMS published in July, which would have hiked fees 2.8%.
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The American Hospital Association characterized the outpatient prospective payment system final rule for calendar 2024 as insufficient.
"The AHA is concerned that CMS has again finalized an inadequate update to hospital payments. Today's increase for outpatient hospitals of only 3.1% comes in spite of persistent financial headwinds facing the field," Executive Vice President Stacey Hughes said in a news release. "Hospitals’ and health systems’ ability to continue caring for patients and providing essential services for their communities may be in jeopardy, which is why the AHA is urging Congress for additional support by the end of the year."
The Ambulatory Surgical Center Association took a positive view, particularly of provisions in the regulation that broaden the services Medicare will cover next year. "Doing so benefits both Medicare beneficiaries, who now have a lower-cost choice for the care they need, and the Medicare program itself, which will save millions of dollars as volume moves to the high-quality surgery center site of service," CEO Bill Prentice said in a news release.
The final rule institutes modifications to hospital pricing transparency laws by calling for hospitals to use a further standardized file format to disclose prices for services. CMS also outlined new enforcement methods that may require hospitals to affirm the accuracy of their pricing information and allow the agency to publicly announce when it takes action against noncompliant providers.
"The AHA will be carefully reviewing the changes to the hospital price transparency rule to ensure they continue to advance our shared objective with CMS of making it easier for patients to access pricing and cost information while reducing unnecessary administrative burden and costs on hospitals and health systems," Hughes said.
In addition, CMS unveiled policies derived from a 2022 statute to promote behavioral health and substance use treatment under Medicare. The final rule establishes the Intensive Outpatient Program, which is intended to expand access for enrollees with mental health needs who do not require hospitalization. Hospital outpatient departments, community health centers, community mental health centers and rural clinics will be able to bill Medicare for these treatments starting next year.
