Cleveland Clinic could take a $22 million loss under a proposed change in federal payments.
U.S. Centers for Medicaid and Medicare is considering sweeping payment changes, including paying the same amount for Medicare clinic visits whether they are at a doctor's office or a hospital outpatient setting.
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The proposed changes are expected to set off a clash between hospital lobbyists and the federal department.
The federal department’s reasoning is that the taxpayer-funded health insurance program should be paying the same amount for services that are essentially the same.
The changes would save Medicare $610 million, and the reduced co-payments would save Medicare beneficiaries about $150 million.
Hospital trade groups have insisted that higher payments for clinic visits at hospital-operated settings are necessary to pay for the higher costs incurred by the larger organizations. Slashed payments could squeeze already thin margins or even cause some hospitals to close.
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Several physician trade groups voiced support for the payments changes, saying it will help even the playing field between independents and hospital-employed physicians.
Cleveland Clinic would lose $22 million of reimbursement for outpatient services from 2018 to 2019, according to Modern Healthcare, which reports news on the health care industry.
Out of the health network examples given, Cleveland Clinic was the biggest loser under the proposed rule change.