Medicare moves to end hospital price premium for routine outpatient care
S. 1629 — Same Care, Lower Cost Act · Filed by John Kennedy (R-LA) · Introduced May 6, 2025 · Referred to committee
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What it does
This bill requires Medicare to pay the same rate for the same medical procedures regardless of where they're performed—whether in a hospital outpatient department, an ambulatory surgical center, or other approved settings—starting in 2027. The Secretary of Health and Human Services must identify at least 66 types of procedures for this 'site-neutral' payment approach, with exceptions for emergency and critical care visits. The goal is to reduce costs by eliminating financial incentives for hospitals to steer patients to higher-cost settings.
Why we flagged it
The bill directly addresses Medicare payment policy to align reimbursement rates across different ambulatory care settings, a structural cost-containment mechanism rather than a subsidy, tax break, or commemorative provision.
What the text implies
- Hospital outpatient departments may experience revenue pressure, potentially leading to service consolidation or reduced investment in certain ambulatory procedures.
- Ambulatory surgical centers (ASCs) and independent clinics may gain competitive advantage and market share as site-neutral rates eliminate the financial premium hospitals previously enjoyed.
The full analysis lists 5 implications of this text.
Who stands to gain
ambulatory surgical centers; independent outpatient clinics; Medicare beneficiaries (via lower costs)