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Statement on 2017 Outpatient Prospective Payment System Final Rule


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

WASHINGTON, DC – Today’s Outpatient Prospective Payment System final rule gives hospitals some relief from the Centers for Medicare & Medicaid Services’ (CMS’) onerous proposals for payment cuts to off-campus clinics, but continues to put underserved communities at risk of further declines in access to care.

We appreciate that CMS provided some flexibility in how it will apply Section 603 of the Bipartisan Budget Act of 2015 – particularly by not limiting existing clinics’ ability to adapt services to meet changing community needs and to relocate after extraordinary events. We also are pleased CMS now will allow payments to both physicians and hospitals for new, off-campus hospital outpatient departments (HOPDs); we will continue to review the agency’s proposed payment rates.

But flexibility provides only partial relief. The inevitable outcome of Section 603 remains: It will make new clinics in underserved communities economically unfeasible and perpetuate health care deserts – urban and rural pockets of limited access to care across the country.

CMS must do more to recognize the practical challenges of establishing and maintaining HOPDs in underserved communities. Unavoidable changes to a clinic’s location or structure – including for many reasons less dramatic than a natural disaster – should not subject it to reduced payments under Section 603.

Essential hospitals support efforts to reduce health care costs, but only when savings can be achieved without harming access and quality. We call on CMS to work with essential hospitals and vulnerable patients to ensure national policies align with these goals.

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Carl Graziano

About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.

Our nearly 275 members are vital to their communities, providing primary care through trauma care, disaster response, health professional training, research, public health programs, and other services. They innovate and adapt to lead the broader health care community toward more effective and efficient care. Learn more at


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