Provider-Based Reimbursement on Thin Ice

Health Care

October 03, 2013
by Jeff Bramschreiber, CPA, Jeffrey Johnson

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Jeff Bramschreiber Jeff Bramschreiber, CPA
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Jeffrey Johnson Jeffrey Johnson
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Hospitals that own and operate medical practices often achieve higher Medicare reimbursement for physician, diagnostic, and other ambulatory services through “provider based” status. However, as Medicare reimbursement reductions are evaluated by the Centers for Medicare and Medicaid Services (CMS) and budget-minded federal policy makers, the reimbursement differential for many services delivered in provider-based settings may be eliminated. Therefore, organizations that depend on the more favorable reimbursement for provider-based services to offset the cost of providing care to Medicare beneficiaries may find it necessary to make substantial changes in future operating expenses to remain financially viable in an ever-changing health care marketplace.
 

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