US medical-industrial complex food chain developments:
Potential Impacts of Medicare Site Neutrality on Off-Campus Drug Administration Costs – Actuarial Research Corporation.
Site-Neutral Payments Could Mean Big Savings for Patients With Chronic Conditions – Arnold Ventures
“New research finds the bipartisan Lower Costs, More Transparency Act will especially help highest-need chemotherapy patients.”
Opinion: ‘Site-neutral’ payments for chemotherapy could save Medicare billions – WaPost
“In practice, though, Medicare’s rules have created an incentive for hospitals to buy up physicians’ practices, at which the hospitals can then charge the higher rate — and pocket the profits. In 2021, Medicare paid hospital rates for more than half of the chemotherapy services it funded, up from a little more than a third in 2012. Indeed, research has found that consolidation among providers brings higher prices for everyone, including private medical insurers (often large corporate employers) and their beneficiaries. Larger medical systems have greater bargaining power in the health-care marketplace. This legislation would also save money for private insurers, which pay hospitals almost double the Medicare rate.
“The Lower Costs, More Transparency Act would basically end these discrepancies for all drugs that must be administered by a health-care provider, as opposed to, say, taken orally at home. Instead, it aims to create ‘site-neutral’ payments. To be sure, $3.7 billion in savings for Medicare over a decade seems small compared with the program’s total projected hospital spending of more than $2.7 trillion. Yet hospitals have been fighting the change furiously, no doubt because of the precedent it would set for other medical services. In fact, that is exactly what should happen. Dozens of services cost more at hospitals, including mammograms, allergy tests, echocardiograms, epidural injections, colonoscopies and laser eye procedures. (The Medicare Payment Advisory Commission has identified 57 such services.) If all were site-neutral, Medicare would save an estimated $150 billion over 10 years.”
The plundering of America’s hospitals – Business Insider
“When hospitals sold off their land, investors got rich. Patients paid the price.”
“In December, Congress announced a bipartisan investigation into private equity’s influence in healthcare. MPT was included on the list of companies that received subpoenas. Sen. Chuck Grassley, the ranking Republican on the Senate Budget Committee, has asked Apollo and Leonard Green to submit details about its deals with MPT, among other things; the Massachusetts congressional delegation is asking Cerberus to account for what happened at Steward. The fundamental question is: Where did all the money go? If Congress does its job and follows the money, it may find itself confronting one of the biggest financial heists in American history — one that transferred billions of dollars from needy patients to greedy investors. Lawmakers aren’t empowered to get any of that money back. But they can at least make MPT and its private-equity partners account for what they got away with.”
“PE-acquired physician practice sites increased from 816 across 119 MSAs in 2012 to 5,779 across 307 MSAs in 2021. Single PE firms had significant market share, exceeding 30 percent in 108 MSA specialty markets and exceeding 50 percent in 50 of those markets. The findings raise concerns about competition and call for closer scrutiny by the Federal Trade Commission, state regulators, and policy makers.”