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Advising the Congress on Medicare issues
MedPAC > Recommendations > Hospital inpatient and outpatient services

Hospital inpatient and outpatient services

March 14, 2014

The Congress should direct the Secretary of Health and Human Services to:

  • reduce or eliminate differences in payment rates between outpatient departments and physician offices for selected ambulatory payment classifications.
  • set long-term care hospital base payment rates for non-chronically critically ill cases equal to those of acute care hospitals and redistribute the savings to create additional inpatient outlier payments for chronically critically ill cases in inpatient prospective payment system hospitals. The change should be phased in over a three-year period from 2015 to 2017.
  • increase payment rates for the acute care hospital inpatient and outpatient prospective payment systems in 2015 by 3.25 percent, concurrent with the change to the outpatient payment system discussed above and with initiating the change to the long-term care hospital payment system.

Topics: Ambulatory care settings, Hospital, and Post-acute care.