Proposed Medicare Payment Policies Aim to Improve Access and Equity
The United States Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have introduced new Medicare payment policies for hospitals and ambulatory surgical centers (ASCs) designed to enhance access to healthcare and promote health equity. These policies are outlined in the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule.
Key Policy Changes:
- Increased Payment Rates: CMS has proposed higher payment rates for hospitals and ASCs that meet quality reporting requirements, based on market trends and productivity adjustments.
- Non-Opioid Pain Relief: Temporary additional payments for non-opioid pain treatments in hospital outpatient departments and ASCs aim to reduce opioid reliance and improve patient outcomes.
- Expanded Access for Indigenous Communities: Indian Health Services (IHS) and tribal facilities would receive separate payments for high-cost drugs, enabling them to expand access to specialty care, such as oncology.
- Enhanced Quality Reporting: CMS proposes expanding quality reporting measures to include equity metrics, helping to identify and address disparities in care.
- Support for Incarcerated Individuals: The proposed rule seeks to eliminate barriers for individuals returning from incarceration to enroll in and maintain Medicare coverage.
For more details information: https://www.allzonems.com/2025-medicare-payment-policies-improve-access-equity/
Choosing an RCM Company:
Selecting the right Revenue Cycle management company depends on factors such as your practice’s size, complexity, specific needs, and budget. Consider partnering with a company specializing in Medical billing with a deep understanding of its complex payment policies.
