Research Study

The Shift to Outpatient Surgery: Geographic Variation and Site-Neutral Payments

With Richard Averill, MS, Rhonda Butler, Danielle Pavloski, Ron Mills, PhD

Medicare payments to providers can vary significantly depending on the site where service is provided. A site-neutral payment policy would equalize payment for the same service irrespective of the site of service, potentially lowering Medicare expenditures. This report describes a method for identifying inpatient surgical cases that could reasonably be performed in an outpatient setting and a method for identifying equivalent outpatient surgical cases. Using equivalent inpatient and outpatient surgical categories, 2018 Medicare fee-for-service (FFS) data was analyzed to compare and measure the shift from inpatient surgery to outpatient surgery across geographic regions, and to evaluate the potential financial impact of a site-neutral inpatient/outpatient payment policy.

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