What New Medicare Rule Changes Could Mean for Patient Costs
Summary
The Trump administration has proposed changes to Medicare payments for outpatient care that aim to lower costs for patients. The plan includes cutting payments for drugs bought through a special discount program and paying the same for certain services regardless of where they are done, but hospitals warn these cuts could hurt care for low-income patients.Key Facts
- The Centers for Medicare and Medicaid Services (CMS) released a rule to change Medicare payments for outpatient care.
- The rule would reduce Medicare payments for drugs bought under the 340B program, which helps hospitals serving low-income patients.
- The proposal aims to make health care more affordable and reduce payment differences based on location.
- Hospitals say the cuts could reduce funding for providers who care for vulnerable populations.
- The rule would increase outpatient care payments by 2.4% starting in 2027, slightly less than last year’s 2.6% increase.
- Medicare would pay less for some outpatient drugs, potentially lowering out-of-pocket costs for patients in the short term.
- CMS plans to expand "site-neutral" payments, meaning some hospital outpatient services would be paid at the same rate as doctor’s offices.
- The changes seek to align drug payments closer to actual hospital acquisition costs.
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