With Congress facing critical funding deadlines, corporate insurance companies and other powerful special interests are pushing lawmakers to enact harmful Medicare cuts to hospital care that would threaten patients’ access to vital health services, especially for those in rural and other underserved communities.
Here are the facts:
- Hospitals and health systems invest in Hospital Outpatient Departments (HOPDs) to better provide important health care services to patients in their communities. Proposals to cut Medicare reimbursements at these facilities fail to account for key differences between HOPDs and other sites of care, and cutting hospital care would threaten a critical lifeline for patients.
- Hospitals treat sicker, lower-income Medicare patients with more complex and chronic conditions than those treated in independent physician offices or ambulatory surgery centers.
- Hospitals and their staff are better equipped to handle complications and emergencies, which often require the use of additional resources that other care settings do not typically provide, such as access to ICUs and other critical hospital services.
- Hospitals treat any patient who walks into the emergency room at any hour of the day.
- Hospitals are held to stricter regulatory and safety requirements than other sites of care.
- Mounting financial pressure due to Medicare and Medicaid underpayments from the government and lack of prompt payments from corporate insurance companies is already threatening patient access to local hospital care in communities across America.
- Despite the vital role hospitals play in our health care system, a majority operated at a loss in 2022.
- More than 149 rural hospitals have been forced to close or reduce their services while hundreds more are at risk of closing.
- While Medicare has historically reimbursed hospitals below the cost of providing care to patients, newly released data shows that Medicare payment levels hit record lows in 2022. A recent analysis finds that Medicare paid just 82 cents for every dollar spent by hospitals caring for Medicare patients in 2022 – the most recent data available. This resulted in $99.2 billion in Medicare underpayments that year alone, nearly two and a half times the amount of underpayments in 2012.
Hospitals and health systems throughout the nation provide patients with critical care 24/7 despite being under financial strain. Lawmakers must reject proposed Medicare cuts to hospital care, which threaten patients’ access to essential health services and would fall disproportionately on rural America and underserved communities.