Oct 15, 2019

Hospitals' increasing revenue from outpatient testing

Caitlin Owens, author of Vitals

Photo by John Moore/Getty Images

The gap between what hospitals and physician offices were paid by fee-for-service Medicare for outpatient cardiovascular tests increased between 2005 and 2015, as did the proportion of these tests that took place in hospitals, according to a new study in JAMA Internal Medicine.

Between the lines: When payment rates depended on where the tests were performed, there was a shift in volume toward the more expensive location.

  • The same didn't happen within a comparison group of 3 health maintenance organizations, for which reimbursement wasn't tied to the testing location.

By the numbers: Traditional Medicare paid hospitals 1.05 times more than doctors' offices for testing in 2005. This increased to 2.32 times more in 2015.

  • Meanwhile, the proportion of hospital-based testing increased from 21.1% in 2008 to 43.2% in 2015. In the control group, the proportion decreased from 16.6% to 15.2%.
  • This shift to the hospital setting cost an estimated $661 million in 2015.

Why it matters: Hospitals have fought fiercely against measures to create site-neutral payments, which the Trump administration proposed last year. The rule was recently overturned in court.

  • Advocates of site-neutral payments say they save taxpayers and seniors money.
  • "Site-neutral payments may offer an incentive for testing to be performed in the more efficient location," the authors of the study write.

Go deeper: Why Medicare is going after hospital outpatient rates

Go deeper

Trump walks to historic St. John's Church outside White House as protests rage

President Trump walked to the historic St. John’s Episcopal Church, located just steps away from the White House across Lafayette Park, on Monday night as protests linked to the murder of George Floyd raged across the capital and cities around the country.

What we're seeing: Military police and park rangers used physical force and tear gas on peaceful protestors to clear the area so that Trump could "pay respects" to the church that was damaged by a fire on Sunday.

Trump threatens to deploy military amid national unrest

President Trump announced from the White House Rose Garden Monday evening that he is "mobilizing all available federal resources, civilian and military" to stop violent protests across the country, decrying "professional anarchists, looters, criminals, antifa and others" whose actions have "gripped" the nation.

The backdrop: Trump's announcement came as police clashed with protesters just outside of the White House, using tear gas and rubber bullets to disperse crowds chanting, "Hands up, don't shoot," and other slogans. Flash bangs used outside the White House could be heard from the Rose Garden.

Updated 2 hours ago - Politics & Policy

Autopsies say George Floyd's death was homicide

Police watch as demonstrators block a roadway while protesting the death of George Floyd in Miami. Photo: Joe Raedle/Getty Images

Preliminary results from an independent autopsy commissioned by George Floyd's family found that his death in the custody of Minneapolis police officer Derek Chauvin was "homicide caused by asphyxia due to neck and back compression that led to a lack of blood flow to the brain," according to a statement from the family's attorney.

The latest: An updated official autopsy released by the Hennepin County medical examiner also determined that the manner of Floyd's death was "homicide," ruling it was caused by "cardiopulmonary arrest complicating law enforcement subdued, restraint, and neck compression."