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Statement on 2019 Outpatient Prospective Payment System Final Rule


Statement attributable to:
Bruce Siegel, MD, MPH
President and CEO
America’s Essential Hospitals

WASHINGTON – Today’s final Medicare outpatient payment rule for 2019 undermines stability and choice for vulnerable patients by continuing to cut critical funding to hospitals serving people who face barriers to care. In finalizing this rule, the Centers for Medicare & Medicaid Services (CMS) not only goes against the intent of Congress but, most importantly, exceeds its statutory authority.

While we appreciate the agency’s decision not to reduce payments for clinics that expand services to meet patient needs, this new rule exacerbates existing cuts to clinic payments and to hospitals that provide affordable drugs in underserved communities. These cuts targeting the nation’s safety net have irreparably harmed low-income patients and the hospitals that serve them.

It’s especially troubling that CMS has framed these changes as empowering patients and providing more affordable choices and options. In fact, these changes create new road blocks to care in communities with chronic provider shortages—health care deserts plagued by severe economic and social challenges.

The rule’s cuts to hospitals in the 340B Drug Pricing Program and expansion of site-neutral payment policy flout congressional intent in two ways: by draining support from the very hospitals Congress sought to shield from sky-rocketing drug prices, and by erasing the clear dividing line lawmakers drew to protect established clinics from these damaging reductions. The hospitals hit hardest by these measures are those least able to afford cuts, as many operate at or below the break-even point.

These ill-advised attempts to cut costs come at the expense of health in our poorest neighborhoods and the viability of hospitals that care for our sickest, most vulnerable patients. We will continue to strongly oppose these reductions and work to reverse the harm they cause.

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About America’s Essential Hospitals
America’s Essential Hospitals is the leading champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. We support our more than 325 members with advocacy, policy development, research, and education. Communities depend on essential hospitals to provide specialized, lifesaving services; train the health care workforce; advance public health and health equity; and coordinate care. Essential hospitals innovate and adapt to lead the way to more effective and efficient care. Learn more at

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